P-Value and confidence intervals - facts and farces

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Children not receiving adequate immunization in Ibadan, Nigeria: What reasons and beliefs do their mothers have?

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Patient Satisfaction with Care Provided at the Antiretroviral Clinic of the Federal Medical Centre, Makurdi, Nigeria

Introduction: Patient satisfaction is considered an important indicator of quality of care. In Nigeria, there is a dearth of information on patient satisfaction with HIV/AIDS care. This study sought to assess patient satisfaction; and to identify associated factors.Methodology: A cross-sectional survey of patients at the antiretroviral clinic of the Federal Medical Centre, Makurdi, Nigeria, was conducted between June and August 2008. An adapted version of the RAND Patient Satisfaction Questionnaire Long Form was used to assess seven dimensions of care: general satisfaction, technical quality, interpersonal manner, communication, financial aspects, time spent with doctor, and access/availability/convenience. Data were analyzed using SPSS 16. Associations were tested using chi-square and multivariable logistic regression. Statistical significance was set at 5%.Results: Of 409 respondents, 108 (26.4%) were males and 301 (73.6%) females. Mean age was 35.7 ± 9.4 years, 86 (21%) had primary school education, 210 (51.3%) were married, and 357 (87.3%) were employed. About two-thirds (65.2%) spent less than 60 minutes waiting for the doctor, and 225 (63.6%) spent at least 10 minutes in consultation with the doctor. Satisfaction rates were: 94.9% technical quality, 90.2% communication, 77.8% interpersonal manner, 67.5% general satisfaction, 57% access/availability/convenience, 46% time spent with doctor, and 45.7% financial aspects. Lower education and waiting less than 60 minutes for the doctor were independently associated with satisfaction across multiple dimensions of care.Conclusion: Respondents were satisfied with the seven dimensions of care to varying degrees. Attending to patients promptly would improve satisfaction, and thus, quality of care.Keywords: Patient satisfaction, antiretroviral clinic, quality of car

Knowledge, attitude and control practices of sickle cell disease among youth corps members in Benin City, Nigeria

Background: Sickle cell disease (SCD) is a major public health problem in Nigeria. Carrier prevalence is about 25% and it affects about 2 – 3% of the Nigerian population. The disease runs a chronic course, characterized by recurrent ill-health, progressive organ damage and shortened life-span. There is a need for SCD control through public education and other preventive measures.Objectives: This study aimed at assessing the level of knowledge regarding SCD among a cross-section of new tertiary graduates in Nigeria, as well as factors influencing their knowledge. It also describes their attitudes and patterns of control practices engaged by the respondents regarding SCD.Methods: This was an analytic, cross-sectional study among 370 new tertiary graduates (youth corps members) in Benin City, Nigeria. Bio data, data on knowledge, their attitude and control practices of sickle cell disease were obtained using a structured questionnaire. Association between the mean level of knowledge and other variables such as age, gender, course of study, etc were tested using one way analysis of variance.Results: Most of the study participants were aged 22 - 29 years. A large proportion (63.5%) of the respondents was females. Only 17.8% of the respondents had a good knowledge of SCD despite high level of awareness (98.4%). Those who studied courses related to medical sciences had significantly higher mean knowledge score. About 94.6% of the respondents knew their SCD carrier status and 80.8% were willing to avoid carrier marriages. Only 38.1% will accept prenatal diagnosis/selective abortion if locally available.Conclusion: Most participants demonstrated moderate level of public health knowledge regarding SCD in Nigeria. Considering the relative lack of prenatal diagnostic services, low acceptability of selective abortion among the respondents, sub-optimal care of affected persons and poor access to haemopoeitic stem cell transplantation (HSCT) in our environment, stronger efforts should be directed and sustained at primary prevention through public education and screening regarding SCD.Keywords: Knowledge, Attitude and practice, Sickle cell disease, New tertiary graduates, Youth corps member

Obstetric fistulae repair in a Nigerian Tertiary Health Institution; Lessons learnt from the outcome of care

This was a hospital based retrospective study of one hundred and fifty-five women managed for obstetric vesicovaginal fistula at the University College Hospital, Ibadan Nigeria from 2000 till 20006. The objective of the study was to document the types of obstetric vesico-vaginal fistula and also describe factors that may influence the outcome of successful repair.The pattern of the fistulae managed were Midvaginal (45.8%),  juxtacervical (38.7%) and juxtaurethral (15.5%). Gynaecologists performed 61.7% of cases using the vaginal route while urologists repaired the rest abdominally. Bivariate analysis showed that younger age at presentation, gravidity, VVF type (Anatomic and Kees Waaldijk), number of previous repairs, and presence of rectovaginal fistula and duration of urinary incontinence prior to repair were statistically significantly related to outcome of repair. Multiple logistic regression models revealed age at presentation (95% CI OR = 1.18 – 9.09) and duration of incontinence (95% CI OR = 1.39 – 13.64) as significant predictors. It is recommended that early presentation for repair and capacity building of specialist trainees will assist in the effective management and other interventions to eliminate obstetric fistula. Above all, governments at all levels should either subsidize or make antenatal care free so as to reduce the incidence of childbirth complications including vesico-vaginal fistula.Keywords: Obstetric fistula, vesico-vaginal fistula (VVF), obstructed labou

Determination of post-caesarean wound infection at the University college hospital Ibadan Nigeria

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Knowledge of the Human Papilloma Virus vaccines, and opinions of Gynaecologists on its implementation in Nigeria

The objective of this study was to determine the knowledge and perception of Nigerian Obstetricians and Gynaecologists towards human papilloma virus vaccine use in Nigeria. A cross sectional study was conducted amongst participants that attended the 42nd Society of Gynaecology and Obstetrics of Nigeria. The findings revealed that 44.5% knew the correct HPV vaccine schedule. Regarding implementation in Nigeria, 87.4% suggested its incorporation into the national immunization program and about a third agreed that it should be a precondition for school enrolment. Regression analysis showed that senior residents were more likely to have adequate knowledge of the vaccine compared to junior residents (AOR 7.181 95% CI OR=1.792 – 28.782). We conclude that the knowledge of eligibility and schedule is poor. It is recommended that adequate information should be provided to this group of health workers because of their strategic position in its implementation in Nigeria (Afr J Reprod Health 2013); 17[2]:150-156).Keywords: Human papilloma Virus Vaccine, HPV, Knowledge, Perception, Nigeri

Misconception about ultrasound among Nigerian women attending specialist and tertiary health institutions in Ibadan

Background: In women health, ultrasound is well established as a safe tool, and it is often the first imaging modality employed in the, screening, investigation and treatment of conditions in obstetrics and gynaecology. However, women's misconceptions about health issues, aetiology and treatment of diseases conditions may have negative impact on their health care seeking behaviour. Client's perspective of diagnosis including investigation process is therefore crucial in health care. This study aimed at finding out the misconceptions expressed by clients about ultrasound, and the potential predictors associated with this attitude among women in Nigeria.Method: A descriptive cross-sectional survey was conducted among 3137 women who presented for transabdominal ultrasound scan between August and November 2010 in two referral hospitals in Nigeria. Data were obtained using a questionnaire. Descriptive and multivariate analysis was performed applying logistic regression analysis; predictors of misconceptions  expressed by clients about ultrasound, and misconceptions among women in Nigeria were identified using SPSS Statistics (SPSS Inc, Chicago, IL) version 17 software.Results: The mean age of the women was 33.8 years (standard deviation = 7.9), with 88.8% currently married. More than half of the responders had tertiary education (56.6%), followed by secondary school education  (34.5%), primary education (7.8%) and no formal education (1.1%). There were 59 women who held the misconception that ultrasound was dangerous to health accounting for 1.9% of the study population. The reasons given by this group of women Included; 'ultrasound can kill or destroys the body cells' (35.6%); it can cause cancer (15.3%); 'the radiation is only dangerous to some organs of the body' (6.8%); it can harm or deform the fetus (6.7%); it is only dangerous when exposure is frequent (5.1%); and only dangerous when handled by unskilled medical personnel (1.7%).Conclusion: This study provides insight to the wide range of issues about clients' perception and misconception regarding ultrasound safety. These issues have to be addressed to improve better compliance and patronage about ultrasound scans in Nigeria. We suggest that robust counseling session is imperative to address all the views and possible concerns of clients to improve better service delivery

Knowledge and use of emergency contraception by medical doctors on internship in a tertiary healthcare facility in Nigeria

Context: Emergency contraception (EC) is widely used to prevent unwanted pregnancy and it is largely adopted in many countries as over the counter drug to improve access.Aims: To determine and compare the correct knowledge, attitude and current use of EC among newly graduated medical doctors (MDs).Settings and Design: A cross.sectional study conducted among 255 newly graduated MDs at the University College Hospital, Ibadan, Nigeria.Materials and Methods: A pretested self.administered questionnaire was used to obtain data from consenting participants.Statistical Analysis Used: Descriptive, bivariate, and multivariable analyses were performed, and statistical significance was set at 0.05. Statistical Package for Social Science version 15.0 (Chicago, IL, USA) software was used.Results: The mean age of the respondents was 27.2 years (standard deviation = 2.1). The commonest indication for emergency contraceptive use mentioned was rape.96.5%. About 70% support EC in Nigeria, while about a quarter (26.9%) routinely counsel women about ECP use. About 21% of respondents currently use EC. Logistic regression analysis revealed significant results for gender [odds ratio (OR) =3.64; 95% confidence interval (CI) OR = 1.31.10.01), religion (OR = 0.26; 95% CI OR =  0.11.0.630) and marital status (OR = 0.19; 95% CI = 0.07.0.56). Conclusion: The correct knowledge and professional disposition toward EC as a form of contraception is low. We recommend that in.service training  should focus more on EC to improve the quality of their knowledge and  attitude towards it.Key words: Emergency contraception, knowledge, Medical Doctor, Nigeri

Clients' reasons for prenatal ultrasonography in Ibadan, South West of Nigeria

<p>Abstract</p> <p>Background</p> <p>Prenatal ultrasonography has remained a universal tool but little is known especially from developing countries on clients' reasons for desiring it. Then aim was to determine the reasons why pregnant women will desire a prenatal ultrasound.</p> <p>Methods</p> <p>It was a cross-sectional survey of consecutive 222 women at 2 different ultrasonography facilities in Ibadan, South-west Nigeria.</p> <p>Results</p> <p>The mean age of the respondents was 30.1 ± 4.5 years. The commonest reason for requesting for prenatal ultrasound scans was to check for fetal viability in 144 women (64.7%) of the respondents, followed by fetal gender determination in 50 women (22.6%. Other reasons were to check for number of fetuses, fetal age and placental location. Factors such as younger age, artisans profession and low level of education significantly influenced the decision to check for fetal viability on bivariate analysis but all were not significant on multivariate analysis. Concerning fetal gender determination, older age, Christianity, occupation and gravidity were significant on bivariate analysis, however, only gravidity and occupation remained significant independent predictor on logistic regression model. Women with less than 3 previous pregnancies were about 4 times more likely to request for fetal sex determination than women with more than 3 previous pregnancies, (OR 3.8 95%CI 1.52 – 9.44). The professionals were 7 times more likely than the artisans to request to find out about their fetal sex, (OR 7.0 95%CI 1.47 – 333.20).</p> <p>Conclusion</p> <p>This study shows that Nigerian pregnant women desired prenatal ultrasonography mostly for fetal viability, followed by fetal gender determination. These preferences were influenced by their biosocial variables.</p