Patterns and predictors of exclusive breastfeeding among mothers in Ile Ife, Nigeria

Background: Exclusive Breast Feeding (EBF) is a cost effective intervention in saving under-five children’s lives in the resource poor settings. However, EBF rates have been shown to be low in these regions with variation in the duration of EBF.Objective: The aim of this study was to assess pattern and predictors of EBF among mothers attending well infant clinic at Obafemi Awolowo University Teaching Hospital Complex (OAUTHC) Ile Ife.Materials and Methods: It was a cross-sectional study carried out between October and December 2014. A total of 250 eligible mothers were selected by simple random sampling among women attending well infant clinic OAUTHC, Ile Ife.A semi-structured selfadministered questionnaire was used.Results: The prevalence of EBF in this study was 23%. The pattern of EBF seen was in the duration of EBF. About 60% gave breast milk alone to their children only in the first month of life. Only 23% was breastfed exclusively for four to five months, while 5% breastfed exclusively for at least six months. About 40% practiced mixed feeding right from the first day of life.The predictors of EBF identified include; ANC attendance, a birth interval greater than or equal to 2 years, husband's positive attitude, giving breast milk as the first feed in life, and vaginal delivery.Conclusion: The practice of EBF within 4 to 6 months of life is still very low. Strategies that target improving access to quality ANC, and emphasize husbands’ roles in encouraging EBF should be giving priority.Keywords: Pattern, predictors, exclusive breastfeedin

PREDITORS AND ACCEPTABILITY OF HUMAN PAPILLOMA VIRUS VACCINE UPTAKE AMONG SENIOR SECONDARY SCHOOL STUDENTS IN ILE-IFE

Introduction: Cervical cancer is the second most common cancer in women worldwide and in Nigeria. Human papilloma virus (HPV), has been implicated as the causative agent of cervical cancer. The fact that HPV vaccination can prevent the occurrence of this deadly cancer is well established. Though the vaccine has been licensed in Nigeria since 2008 with widespread availability, it is yet to be included in National immunization program in Nigeria. This study aimed to assess the predictors and acceptability of the HPV vaccine among senior secondary girls in Ile-Ife. Methods: This descriptive cross-sectional study recruited 400 students randomly selected from various secondary schools in Ife central-local government. The data was collected with the use of a pre-tested interviewer-administered questionnaire on knowledge, attitude, and acceptability of cervical cancer, HPV and HPV vaccine. Data were analyzed using descriptive and inferential statistics. Results: Most respondents (93.2%) had poor knowledge of cervical cancer, HPV and HPV vaccine. Attitude towards cervical cancer and HPV vaccine was good and the majority (74.5% ) had high acceptability for the HPV vaccine. Only 2.8% of the respondents have been vaccinated. Predictors of acceptability of HPV vaccine were younger age group ((AOR) 4.05 ,CI= 2.30-5.45), good knowledge ((AOR =2.50,CI=2.31-6.83) , mother’ higher level of education (AOR= 1.55, CI=2.62- 4.58 ), perceived fatality of cervical cancer ( AOR=4.13,CI=1.49 – 4.19) and perceived efficacy of the HPV vaccine( AOR=1.57, CI= 0.49 – 3.18). Conclusions: The knowledge of secondary school girls in the study area on cervical cancer, HPV and HPV vaccine is poor though the HPV vaccine acceptability is high. The high acceptability of the vaccine in this study is a reflection of the willingness of this vulnerable group to learn more about the subject matter. There is the need to create school health programs that will focus on health educating the students on this preventable cancer and the available vaccine. Including HPV vaccine into National immunization program in Nigeria may also improve awareness of cervical cancer and the vaccine uptake

Contraceptive uptake among women attending family planning clinic in a Nigerian tertiary health facility: a 6 year review

Background: Contraceptive uptake is one of the most important determinants of pregnancy rates and birth rates in the world. Aim: To determine the principal trends in contraceptive use from 2004-2009 in the family planning unit of a tertiary health centre in South-Western Nigeria, and to identify the effect of age, marital status and parity on the choice of contraceptive method.Methods: The record of 1,862 clients attending the Family Planning unit of Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun-State, Nigeria for the period between 2004-2009 were reviewed. Information related to the age, marital status, parity and the choice of contraception were obtained using a structured proforma and the data analyzed with SPSS version 16. Pearson chi-square test was used as test of significance where applicable.Results: Within the study period, the contraceptive uptake was 13.2%. Copper-T IUCD was the most commonly used method of contraception (77.9%), followed by the progestogen only injectable contraceptives (12.6%), then oral pills (4.1%) and progestin implants (2.3%). Single women and women of low parity are more likely to use pills than IUCD (69% vs. 38.3%) while long acting reversible contraception (injectables and IUCD) are preferred by women with higher parity (P=0.000).Conclusions: IUCD is the most popular method of contraception in Ife-Ijesha area of Nigeria. Contraceptive uptake is relatively low among the women. Age and parity are key influences on the uptake and choice of contraception practiced by the women, while the influence of marital status is not statistically significant

THE BURDEN OF VESICO-VAGINAL FISTULA IN ILE-IFE, SOUTH WESTERN NIGERIA

Background: Vesicovaginal fistula is a major cause of severe morbidity and potential mortality, which can result in marital disruption, rejection, and eventual destitution. Methodology: A retrospective study of all cases of vesicovaginal fistula managed over a 30 year period between 1st January 1984 and 31st December 2013 at the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria. Relevant data were obtained from the case notes and analyzed for the demographics, clinical features, management and outcome using SPSS version 20. Result: There were 213 patients with vesicovaginal fistula over the period of the study with aprevalence of 3.9 per 1000 deliveries. The age range was 15-45 years with a mean age of 24.8 years. Most of them were primiparous, (52.1%) and of the low social class (84.5%). Obstetric fistula accounted for 93.9%. The majority of them (64.8%) did not have antenatal care during the antecedent pregnancy. Labor was attended by unskilled attendants in about 90% of them while 92% labored for at least 24hours. The juxta-cervical fistula was the most common anatomical type (47.0%). The overall success rate at repair was 76.4%. Stillbirth rate in the antecedent pregnancy was 67.5%. Other associated morbidities included chronic vulva excoriation, obstetric palsy, and secondary amenorrhea. Conclusion:Vesicovaginal fistula (VVF) is a major public health problem in developing countries with too many calamities as shown in this study. Improving the educational and economic status of women in Nigeria will go a long way in empowering them to access quality antenatal care. This will also enhance hospital delivery thereby preventing prolonged obstructed labor which is a strong etiological factor for VVF. Decentralization of treatment centers and training of specialists in fistula surgery is very important to improving treatment outcomes

Activities of Amodiaquine, Artesunate, and Artesunate-Amodiaquine against Asexual- and Sexual-Stage Parasites in Falciparum Malaria in Children

The activities of amodiaquine, artesunate, and artesunate-amodiaquine against asexual- and sexual-stage parasites were evaluated in 360 Nigerian children with uncomplicated Plasmodium falciparum malaria randomized to the standard dose regimens of the three drugs/combination. Clinical recovery from illness occurred in all children. There were no significant differences in fever clearance times. Patients treated with artesunate or artesunate-amodiaquine had significantly shorter parasite clearance times (1.4 ± 0.5 days or 1.4 ± 0.6 days versus 3.2 ± 2.3 days, P = 0.0001) and lower gametocyte carriage rates (3.3 or 1.7% versus 11.7%, P = 0.001) than those treated with amodiaquine alone. Gametocytemia was detected in 62 patients (11.7% before treatment and 5.6% after treatment). The pretreatment gametocyte sex ratio, which was female biased, increased significantly during the course of treatment with amodiaquine but not with artesunate and artesunate-amodiaquine. These results suggest that artesunate and artesunate-amodiaquine reduce gametocyte carriage and may reduce transmissibility in P. falciparum malaria by accelerating asexual clearance and influencing gametocyte sex ratio

Lidocaine 10% sprays versus oral diclofenac sodium for pain relief in women undergoing hysterosalpingography for infertility workup: A randomized clinical trial

ABSTRACTBackground Tubal disease is the leading cause of female infertility in the West African sub-region and hysterosalpingography (HSG) is the first-line imaging technique in its assessment. HSG is an acutely painful procedure. Various studies on analgesia for HSG were inconclusive. We compared the efficacy of 10 mg lidocaine 10% spray and 50 mg oral diclofenac sodium for pain relief during HSG.Methods This randomized clinical trial was carried out at the Department of Obstetrics and Gynecology, Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC) Ile-Ife, Nigeria between December 2019 and December 2021, among one hundred and eight eligible women undergoing HSG as part of their infertility workup. Ethical clearance was obtained from the ethics committee of the hospital with Protocol number ERC/2019/01/14. They were randomized into two groups. One group of 54 patients received 10 mg of 10% lidocaine spray and an oral placebo, while the second group of 54 women had 50 mg of oral diclofenac sodium and normal saline spray. Pain scores were assessed using a 10 cm visual analog scale at cervical traction, instillation of contrast media, and thirty minutes after HSG. The mean pain scores, the need for additional analgesia, and the occurrence of adverse drug reactions were compared between the two groups.Result Those in the oral diclofenac group had significantly lower pain scores than the 10% Lidocaine group 30 minutes after HSG; 1.13 ± 1.06 Vs. 2.04 ± 1.26 (p < 0.001). The additional analgesic requirement also showed no statistically significant difference between the two groups.Conclusion This study showed that oral diclofenac sodium is comparable to lidocaine spray for pain relief during HSG. It also has the additional benefit of improved quality of life 30 mins after HSG as evidenced by effective pain relief. Consideration should be given to the use of oral diclofenac sodium for pain relief during and after HSG in well-selected patients

ECTOPIC CHORIOCARCINOMA IN A PRETEEN IN OGBOMOSO, SOUTH-WEST NIGERIA. A CASE REPORT

Ectopic Choriocarcinoma is an extremely rare occurrence. The case of ectopic choriocarcinoma discussed here involved a 12 year old girl who presented with lower abdominal pain and dizziness following a short period of amenorrhea after attaining menarche. Aprovisional diagnosis of ruptured ectopic gestation was made based on the clinical evaluation and patient had emergency laparotomy. Histopathology report revealed a choriocarcinoma of the ovary. Patient defaulted on subsequent follow up care. This case is presented as an eye opener on the need to also focus on the reproductive health challenges, early sex education in preteen and rare occurrence of the disease amongst the Pre-teenage groups. It is also important to deal with the possibility of a non gestational choriocarcinoma of the ovary which has a worse prognosis

Enhancement of the antimalarial efficacy of amodiaquine by chlorpheniramine in vivo

Resistance in Plasmodium falciparum to amodiaquine (AQ) can be reversed in vitro with with antihistaminic and tricyclic antidepressant compounds, but its significance in vivo is unclear. The present report presents the enhancement of the antimalarial efficacy of AQ by chlorpheniramine, an H1 receptor antagonist that reverses chloroquine (CQ) resistance in vitro and enhances its efficacy in vivo, in five children who failed CQ and/or AQ treatment, and who were subsequently retreated and cured with a combination of AQ plus CP, despite the fact that parasites infecting the children harboured mutant pfcrtT76 and pfmdr1Y86 alleles associated with AQ resistance. This suggests a potential clinical appliation of the reversal phenomenon

Enhancement of the antimalarial efficacy of amodiaquine by chlorpheniramine in vivo

Resistance in Plasmodium falciparum to amodiaquine (AQ) can be reversed in vitro with with antihistaminic and tricyclic antidepressant compounds, but its significance in vivo is unclear. The present report presents the enhancement of the antimalarial efficacy of AQ by chlorpheniramine, an H1 receptor antagonist that reverses chloroquine (CQ) resistance in vitro and enhances its efficacy in vivo, in five children who failed CQ and/or AQ treatment, and who were subsequently retreated and cured with a combination of AQ plus CP, despite the fact that parasites infecting the children harboured mutant pfcrtT76 and pfmdr1Y86 alleles associated with AQ resistance. This suggests a potential clinical appliation of the reversal phenomenon