The effect of free distribution of insecticide-treated nets on asymptomatic Plasmodium parasitemia in pregnant and nursing mothers in a rural Nigerian community

INTRODUCTION

Malaria is a major public health problem in Nigeria, with adverse outcomes on the poor, pregnant women and children living in rural communities. A major component of current intervention in roll back malaria (RBM) initiative is vector control and insecticide-treated nets (ITNs).

AIMS AND OBJECTIVE

This research studied the impact of free distribution of ITNs on malaria parasitemia in a rural community in Nigeria.

MATERIALS AND METHODS

This is a longitudinal survey involving 990 pregnant and nursing mothers who received free ITNs between February 2007 and September 2008. Blood samples were collected at contact, then every 2 months to check for malaria parasites using standard methods.

RESULT

There was a sustained but insignificant rise in asymptomatic malaria parasitemia post-distribution of ITNs.

CONCLUSION

We conclude that ITN intervention remains important in malaria prophylaxis but must be complemented with awareness campaigns and other vector control strategies.

Women's perception as a barrier to focused antenatal care in Nigeria: the issue of fewer antenatal visits

The attitude of pregnant women to a new antenatal care model with four antenatal visits (focused antenatal care) is examined using a cross-sectional survey in Enugu, Nigeria. Only 20.3% of the parturients desired a change to the new model. Parturients who defaulted from antenatal care three or more times, those dissatisfied with their current antenatal care, senior civil servants and parturients who received secondary school education or less most commonly desired a change to the new model (P < 0.05). Default from antenatal care and dissatisfaction with current antenatal care were most predictive of the desire for change in multiple logistic regression analysis. The most common reasons for desiring the change were convenience (65.1%) and cost considerations (24.1%). Reasons given for the rejection of the new model were: fear of inadequate learning during antenatal care (45.7%), the suspicion that four visits were inadequate for familiarization with care providers (12.9%), the need for early detection of disease (6.7%) and social satisfaction from antenatal visits (6.7%). These concerns are amenable to change by health education and social mobilization.

Knowledge and beliefs about exclusive breastfeeding among rural Nigerian men in Enugu, Southeast Nigeria

AIM

This study evaluated the knowledge, beliefs, and attitude of rural Nigerian men to exclusive breastfeeding.

SUBJECTS AND METHODS

A sample of 200 men drawn from a rural community in Enugu, Nigeria was studied.

RESULTS

One hundred fifty-four (82.4%) respondents had heard of exclusive breastfeeding. Only 29.9% knew the correct time for initiation of exclusive breastfeeding, while 30.5% believed that breastmilk alone was sufficient for the first 6 months of life of an infant. One hundred six (56.7%) accept the practice of exclusive breastfeeding, while 38.5% accepted that colostrum is safe for a child. Reasons for rejecting colostrum were chiefly because it is perceived as poisonous, dirty milk and culturally unacceptable. Educational status and age significantly affected knowledge and acceptance of exclusive breastfeeding among the respondents.

CONCLUSION

There is a critical need to target men for intensive breastfeeding education.

Awareness and practice of cervical cancer screening among female undergraduate students in a Nigerian university

Cervical cancer screening enhances early detection which reduces morbidity and mortality. The objective of this study is to assess awareness and practice of cervical cancer screening amongst female students in a Nigerian university. A cross-sectional survey of 394 students was done. About 23.1% identified the Pap smear as a screening test. Only 5.2% of respondents had ever been screened and 52.8% reported willingness to be screened. The major reason for unwillingness to get a Pap smear was absence of symptoms (31.7%). There is a critical need to improve cervical cancer screening participation amongst female undergraduate students in Nigeria.

Knowledge, perceptions and practices of lifestyle-modification measures among adult hypertensives in Nigeria

Hypertension remains the most rapidly rising cardiovascular disease in Africa. This study was designed to evaluate the perception, knowledge and practices of Nigerian hypertensive patients regarding hypertension and lifestyle modification measures. Consecutive hypertensive patients attending the cardiac clinics of the University of Nigeria Teaching Hospital, Enugu, Nigeria, were recruited. A pre-tested structured interviewer-administered questionnaire was used to collect data. Questions were categorised to elicit patients' demographic characteristics, knowledge, perception and practice of various lifestyle-modification measures. chi(2) tests were performed. More than half (54.2%) of the 260 respondents had no formal, or just primary, education. About 25% were no longer taking their antihypertensive medication. Fifty per cent of the patients thought that hypertension was caused by stress. Most knew about the lifestyle measures through health personnel. More than 50% adopted the lifestyle-modification measures once they became aware of their effects. This study has shown a poor level of perception of hypertension and awareness of the lifestyle-modification measures through the mass media, but a high level of willingness to adopt the lifestyle measures. Concerted strategies are required to change the perception of hypertension and increase the awareness of the lifestyle-modification measures in this part of the world.

HIV/AIDS-related knowledge, sexual practices and predictors of condom use among long-distance truck drivers in Nigeria

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Prevalence of depressive symptoms among Nigerian medical undergraduates

This study assessed the epidemiology of depressive symptoms in Nigerian medical students. A cross-sectional study of 262 medical students from University of Nigeria, Enugu campus, one of the foremost medical schools in Nigeria was studied. Data were collected using structured self-administered questionnaires and the Zung self-rating depression scale developed by Zung as an instrument, which measures the subjective experience of depression. The age range of students was 16-30 years. The prevalence of depression among the students was 23.3%. Students aged 16-20, females, and those who had a professional examination during the period of the study had higher levels of depression, although these findings were not significant. However, students who smoked regularly had significantly higher levels of depression than those who did not smoke. Medical educators in Nigeria need to be aware of the vulnerability of medical students to depression.

A risk assessment for pregnancy using the World Health Organization classifying form in primary health-care facilities in Enugu, Nigeria

We present a cross-sectional survey of the pattern of high-risk pregnancies in randomly selected primary health-care facilities in Enugu, Nigeria, using the World Health Organization's classifying form. None of the 10 maternity homes studied had a standard risk screening tool. The age of the 299 women studied ranged from 16 to 42 years with a mean of 27.8 +/- 6.7 years. Eighty-eight (29.4%) of them were nulliparous, 160 (53.5%) were multiparous and 51 (17.1%) grandmultiparous. One hundred and twenty (40.1%) respondents were in the high-risk category. Rhesus D-negative blood group parturients (42, 35.0%), previous perinatal deaths (29.2%) and multiple pregnancies (9.2%) were the most common risk factors. The prevalence of high-risk pregnancies significantly increased with maternal age and parity and was not influenced by an improved maternal educational attainment. The institution of screening for high-risk pregnancies is vital at the primary health-care level and must be emphasized and must be regularly audited.

Adoption practices in Enugu, Nigeria

OBJECTIVE

The study of the pattern and outcome of adoptions in Enugu, Nigeria in order to determine the challenges in the emerging adoption practice in the state.

MATERIALS AND METHODS

A retrospective analysis of adoption practices in Enugu Nigeria based on data from the National women's Commission. The National Women's Commission is the statutory body responsible for the documentation and follow-up of adoption in Enugu State. The characteristics of adopters and adoptees, types of adoption, prevalence and outcome of the adoptions between January 1991 and December 2001 were examined. Percentages were used for descriptive statistics and student's t-test for comparing means at 5% significance levels.

RESULTS

There were sixty-one adoptions in the eleven-year period giving a prevalence of 5.5 adoptions per year. Eighteen (29.5%) kinship adoptions and 43 (70.5%) adoptions of abandoned babies and children were recorded. The mean age of the adoptees was 4.2 years and 33.3% of them were 5 years and above. All adopters were Nigerians but 32.0% of them resided overseas. The commonest age range at adoption was 4-49 years and the peak duration of marriage prior to adoption was 15-19 years. Most adopters (84.9%) had at least secondary school education. No adoption was annulled and there was no recorded death of adoptees. Post care monitoring was found to be incomprehensive.

CONCLUSION

The growing practice of adoption in Enugu is laudable but post adoption care is poor. Emphasis on post adoption care is vital in developing countries where complex social and logistic factors militate against it. In infertility management early institution of counseling on adoption would allow couples ample time for decision making and preparation for adoption, as well as encourage adoption when couples are still young.

Knowledge and attitude of secondary school teachers in Enugu to school based sex education

OBJECTIVE

To assess the knowledge and attitude to sex education among secondary school teachers in Enugu.

MATERIALS AND METHODS

A cross sectional study of 300 teachers drawn from nine randomly selected secondary schools in Enugu metropolis was carried out. Pre-tested self administered structured questionnaire was used as instrument for data collection.

RESULTS

Three hundred teachers, 215 females and 85 males were interviewed. The mean age of the teachers was 38.1+/-7.5 years. Sixty-nine (23.0%) had adequate knowledge of sex education and 282 (94.0%) approved the inclusion of sex education into the school curriculum. The commonest reason for disapproval of sex education was fear that it would lead to promiscuity amongst the students. Educational status and marital status of the teachers were significant determinants of positive attitude to sex education p<0.05. The most appropriate age to introduce sex education according to the teachers is 11-15 years. Two hundred and thirty eight (79.3%) respondents were of the opinion that teachers needed to be trained to provide sex education to students and 244 (81.3%) admitted that sex education was not in the school curriculum.

CONCLUSION

Secondary school teachers are in support of provision of sex education to students. However they need training and skills on how to present sex information in a positive manner to achieve the desired goal. There is need to include sex education in the school curriculum.

HIV/AIDS perception and sexual behaviour among Nigerian University students

OBJECTIVE

To evaluate the knowledge and perception of undergraduate students of the University of Nigeria with regards to HIV/AIDS and determine their sexual behaviour.

MATERIALS AND METHODS

This was a cross sectional descriptive study. Pre-tested structured questionnaires were administered to the students to collect relevant information on their sociodemographic characteristics, HIV/AIDS awareness, sexual behaviour, willingness to screen and disposition to people living with HIV/AIDS RESULTS: Five hundred and seventy nine students between 16 to 40 years of age responded, out of 600. Majority (55%) heard about HIV/AIDS through the media. Seventy two percent believed viruses cause HIV/AIDS but 27% thought it was God's anger or witches. Forty four percent were (genitally) sexually active or engaging in pre/extramarital sexual intercourse and only two-thirds of these used condoms for these purposes. Ninety one percent of those not using condoms simply did not like it or admitted it was unavailable. More than 70% had never had a HIV screening test, mostly due to reluctance or fear. Ninety two percent would lovingly care for a HIV/AIDS patient.

CONCLUSION

Information on HIV/AIDS and sexual behaviour to this vulnerable and most economically important group is still inadequate, as reflective of the society. Appropriate information, education and communication strategies must be packaged towards these students, with efforts made to reinforce their positive trends.

Spectrum of paediatric malignancies in eastern Nigeria (1989-1998)

A 10-year retrospective survey of childhood malignancies in eastern Nigeria was carried out based on data from the University of Nigeria Teaching Hospital Cancer Registry. The aim was to discover the current pattern of paediatric malignancies in the study area. A total of 313 children aged less than 15 years, diagnosed with cancer by means of histological or cytological examination during the study period (January 1989-December 1998) were analyzed. The male-to-female ratio was 1.6:1. The lymphomas constituted the highest prevalence (38.3%) with Burkitt's lymphoma being the commonest (65.8%) of all the lymphomas. These were followed by sarcomas (14.7%), nephroblastoma (14.4%), retinoblastoma (12.1%) and leukaemias (8.6%). The less common ones were teratomas (2.9%) and neuroblastoma (1.9%). Comparison of two clinicopathological studies of childhood cancer in Enugu between 1976-1980 and 1989-1998 showed an increase in the relative frequencies of sarcomas, retinoblastoma, leukaemias and a decline in the frequencies of Burkitt's lymphoma, nephroblastoma, teratomas and neuroblastoma. Further epidemiological studies are necessary in order to determine whether these changes actually reflect the distribution of childhood cancer in the general population and also to elicit the possible mechanisms of carcinogenesis.