Health education alone and health education plus advance provision of emergency contraceptive pills on knowledge and attitudes among university female students in Enugu, Nigeria

This was an intervention study to compare the effects of health education alone and health education plus advance provision of emergency contraception (EC) pills on the knowledge and attitudes to EC by female students of University of Nigeria in South‑East Nigeria.Materials and Methods: Astructured questionnaire was used to collect data in February, 2009 from 290 female students of a tertiary educational institution (140 in the study group and 150 from the control group) who were selected by multistage sampling. Subsequently, health education was conducted among all the students. In addition, a pack containing 2 tablets of EC pills (Postinor) was given only to the students in the study group. Three months after this intervention, its effects were assessed through a survey using the same structured questionnaire employed in the baseline survey.Results: knowledge of EC was significantly higher among the study group than the controls at post‑intervention, P < 0.05. Attitudes to EC were also more favorable at post‑intervention survey among the study group, P< 0.05 in most of the variables.Conclusion/Recommendation: Health education plus advance provision of EC pills effectively improved knowledge and attitudes to EC among female students of tertiary institutions more than health education alone and this should be promoted.Key words: Advance provision, attitudes, emergency contraception, female students, health education, knowledge, tertiary institution

Parental Verbal Communication and Sexual Knowledge of Senior Secondary School Students in South East, Nigeria

BACKGROUND: Parental verbal communication may influence the sexual knowledge of senior secondary school students in Enugu State, Nigeria.METHODS: This study utilized a school based cross-sectional study design and was conducted across the six education zones of Enugu State using three-stage sampling technique. A total of 400 respondents completed the interviewer administered questionnaires on their socio-demographics, sexual knowledge and parents’ information on verbal communication skills. Obtainable knowledge scores for sexuality ranged between 0-10; scores of 1-5 were classified as poor and 6-10 as good. Data analysis for the quantitative data was done using IBM SPSS; version 22. Chi square test of statistical significance and multivariate analysis using binary logistic regression were used in the analysis, and the level of significance was set at a p value of less than 0.05.RESULTS: Out of the 400 respondents, 55.5% were girls. The mean age (SD) of the respondents was 15.9 ± 1.3 years. Although 15.5% and 8.8% of the respondents were very comfortable discussing sexually related matters with their mothers and fathers only 34.8% and 16.0% of mothers and fathers were comfortable discussing such matters with the respondents. Less than half of the respondents (42.5%) had good sexual knowledge. Verbal sexual communication between parents and respondents and age above 16 years were found to be predictors of good sexual knowledge.CONCLUSIONS: Poor parental verbal communication led to the poor knowledge of sexuality among the respondents. Parents should be encouraged to discuss sexuality matters with their children

Assessment of knowledge and factors that may predict willingness to volunteerism: A pilot study of community.directed distributors in Anambra state

Background: Malaria as a leading cause of death in many developing countries requires urgent interventions. In order to improve access to healthcare, trained volunteers are used to distribute health commodities. The present study aims at determining knowledge and factors that may predict willingness to volunteerism in a developing country.Methodology: This was a cross.sectional descriptive study carried out in 2014 among 284 community-directed distributors in three rural communities in Anambra, Southeast Nigeria using pretested  semi-structured questionnaires.Results: The age range of volunteers was 21.79 years. Most (71.8%) are females and are married (83.1). Only 5.6% of the volunteers did not have any formal education. The predominant occupation is trading (52.5). Most volunteers (78.5%) could define the term volunteerism. Less than half (40.1%) knew the resources that could be volunteered. Most (67.3%) felt that volunteerism is most needed in church activities. Many  respondents (58.8%) had volunteered for one or more programs previously. The most common challenge faced was interference with other income generating activities (66.5%). Retired males were more likely to volunteer than retired females (P . 0.01). However, females are more likely to volunteer if the main reason of volunteering is to help people (P . 0.01). The more educated ones believe that volunteerism will help them to be selected for other community programs.Conclusion: Most respondents had volunteered for other programs and the motivating factors included the satisfaction derived from helping others and the hope of being used for other community programs.Key words: Community.directed distributors, knowledge, malaria, volunteeris

Audit of Childbirth Emergency Referrals by Trained Traditional Birth Attendants in Enugu, Southeast, Nigeria

Background: The essence of training traditional birth attendants (TBAs) is to attend to women in uncomplicated labor and to refer them immediately to hospitals when complications develop.Aim: The aim was to audit childbirth emergency referrals by trained TBAs to a specialist hospital in Enugu, Nigeria.Subjects and Methods: A retrospective study of 205 childbirth emergencies referred to Semino Hospital and Maternity (SHM), Enugu by trained TBAs from August 1, 2011 to January 31, 2014. Data analysis was descriptive and inferential at 95% confidence level.Results: Most of the patients (185/205, 90.2%) were married and (100/205, 48.8%) had earlier booked for antenatal care in formal health facilities. There were obstetric danger signs or previous bad obstetric histories (pregnancies with unfavourable outcome) in 110 (110/205, 53.7%) women on admission at SHM. One hundred and fifteen (115/205, 56.1%) women walked into the hospital by themselves while 50 (50/205, 24.39%) could not walk. The fetal heart sounds were normal in 94 (94/205, 45.6%), abnormal in 65 (65/205, 31.8%) and absent in 42 (42/205, 20.4%) of the women on admission. Five healthy babies were delivered by the TBAs before referring their mothers. Delays of more than 12 h had occurred in 155 (155/205, 76.6%) of the women before referrals. Prolonged labor (100/205, 48.8%), obstructed labor (40/205, 19.5%), attempted vaginal birth after previous cesarean delivery (40/205, 19.5%) and malpresentation (30/205, 14.6%) were the common indications for referrals. The maternal mortality and perinatal mortality ratios were 610/100,000 live births and 228/1000 total births respectively.Conclusion: Delays at TBA centers are common before referral and most patients are referred in poor clinical state. Further training and re‑training of the TBAs with more emphasis on recognition of obstetric danger signs and bad obstetric histories may help in screening high‑risk patients for prompt referral to hospitals before complications develop. Keywords: Childbirth emergencies, Delay, Outcomes, Referrals, Trained traditional birth attendant

A review of Lassa fever outbreaks in Nigeria From 1969 to 2017: Epidemiologic profile, determinants and public health response

Introduction: Lassa fever outbreaks have occurred in Nigeria since the 1969 till date. This is in spite of the fact that the reservoir and modes of transmission have been known for all these years. This review aimed at describing the epidemiology and determinants of the Lassa fever outbreaks in Nigeria from 1969 to 2017 and the public health response to these outbreaks.Method: The guidelines for the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were used to conduct the review between May 2017 and January, 2018. We searched PubMed, Science direct, WHO library databases and Google Scholar for articles published from 1970 till January 2018. Other relevant websites such as those of the World Health Organization, Nigeria Centers for Disease Control and Prevention were searched for Lassa fever outbreak reports.Results: Twenty-six articles and reports were included in the final review. These described twenty-one outbreaks involving 5442 suspect cases, 768 confirmed cases and 631 deaths from suspected or confirmed Lassa fever. Thirty-two states and the Federal Capital Territory have ever recorded outbreaks of Lassa fever. Lassa fever cases now occur in various states in Nigeria all year round with dry season peaks. Nosocomial transmission has remained a consistent determinant. Public health responses have changed over time starting from predominantly case management in initial outbreaks to a centrally coordinated response supporting states and institutions over the years.Conclusion; Lassa fever outbreaks have increased in frequency and geographic spread with case fatality ratio remaining unacceptably high. The same determinants have persisted with nosocomial transmission a consistent factor. Public health response has consistently improved with the last two years showing the most coordinated response. We recommend that the definition of Lassa fever in the Nigerian Integrated Disease Surveillance and Notification System (IDSR) be revised to reflect the current reality to ensure better Lassa fever control.Key words: Lassa fever, Outbreak, Viral haemorrhagic fevers, Nigeria