Falls among pregnant women in Enugu, Southeast Nigeria

Background: Falls during pregnancy are major public health issues and a common cause of maternal injury during pregnancy. There is paucity of data on prevalence and risk factors of falls during pregnancy in African population including Nigeria.Objective: To determine the prevalence and risk factors associated with falls during pregnancy in Enugu, Nigeria.Materials and Methods: This was a cross.sectional study of 332 consecutive pregnant women presenting in labor for delivery at the University of Nigeria Teaching Hospital Enugu, Nigeria between 1st May and 31st December, 2012.Results: The mean age of the women was 32.2 } 2.7 (range: 20.42) years. One hundred and eight women (32.5%) reported falling at least once during the index pregnancy. Women aged . 30 years had twofold risk of falling during pregnancy than women aged > 30 years [41.1% (69/168) vs. 23.8% (39/164); odds ratio (OR): 2.23; 95% confidence interval (CI): 1.39.3.58; P < 0.001)]. Similarly, women . 160 cm in height had significantly higher risk of falling during pregnancy than women < 160 cm in height [43.5% (70/161) vs. 22.2% (38/171); OR: 0.37; 95% CI: 0.23.0.60; P < 0.0001)]. Furthermore, primigravidae had almost threefold risk of falling during pregnancy than multigravidae [45.3% (63/139) vs. 23.3% (45/193); OR: 2.73; 95% CI: 1.70.4.37; P < 0.0001)].Conclusion: Falls during pregnancy is common in Enugu, Nigeria. It is, therefore, recommended that women should be counseled during pregnancy on this public health problem and the above.identified risk factors emphasized in order to reduce the prevalence and morbidity.Key words: Enugu, falls, Nigeria, pregnant women, prevalence, risk factor

Risk Factors for Hepatitis B Virus Infection during Pregnancy in South Eastern Nigeria

Objective: To determine the seroprevalence of hepatitis B surface antigen (HBsAg) and possible risk factors in pregnant women.Design: A cross –sectional serological survey of women attending antenatal clinics.Setting: Five antenatal clinics in Aba, South Eastern Nigeria.Subjects: Eight hundred and ten consecutive and consenting antenatal clinic attendees over the period 15 June- 15 November 2010.Main Outcome measures: For each pregnant woman, the medical and sociodemographic data were documented. Hepatitis B surface antigen seropositivity determined.Results: Twenty two (2.7%) of the 810 subjects were found to be HBsAg seropositive and asymptomatic. Maternal age, parity, educational level attained, marital status, history of blood transfusion, intravenous drug use, tattooing, jaundice in the past and Human Immunodeficiency Virus seropositivity did not show any association with HBsAg sseropositivity.Conclusion: HBsAg seropositive women in the study were asymptomatic and showed no association with the medical and sociodemographic characteristics examined. These findings affirm the recommendation for universal HBsAg screening in pregnancy and imply that screening on the basis of the presence of risk factors alone may be insufficient

Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: A systematic analysis for the Global Burden of Disease Study 2017

Background: The Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017) includes a comprehensive assessment of incidence, prevalence, and years lived with disability (YLDs) for 354 causes in 195 countries and territories from 1990 to 2017. Previous GBD studies have shown how the decline of mortality rates from 1990 to 2016 has led to an increase in life expectancy, an ageing global population, and an expansion of the non-fatal burden of disease and injury. These studies have also shown how a substantial portion of the world's population experiences non-fatal health loss with considerable heterogeneity among different causes, locations, ages, and sexes. Ongoing objectives of the GBD study include increasing the level of estimation detail, improving analytical strategies, and increasing the amount of high-quality data. Methods: We estimated incidence and prevalence for 354 diseases and injuries and 3484 sequelae. We used an updated and extensive body of literature studies, survey data, surveillance data, inpatient admission records, outpatient visit records, and health insurance claims, and additionally used results from cause of death models to inform estimates using a total of 68 781 data sources. Newly available clinical data from India, Iran, Japan, Jordan, Nepal, China, Brazil, Norway, and Italy were incorporated, as well as updated claims data from the USA and new claims data from Taiwan (province of China) and Singapore. We used DisMod-MR 2.1, a Bayesian meta-regression tool, as the main method of estimation, ensuring consistency between rates of incidence, prevalence, remission, and cause of death for each condition. YLDs were estimated as the product of a prevalence estimate and a disability weight for health states of each mutually exclusive sequela, adjusted for comorbidity. We updated the Socio-demographic Index (SDI), a summary development indicator of income per capita, years of schooling, and total fertility rate. Additionally, we calculated differences between male and female YLDs to identify divergent trends across sexes. GBD 2017 complies with the Guidelines for Accurate and Transparent Health Estimates Reporting. Findings: Globally, for females, the causes with the greatest age-standardised prevalence were oral disorders, headache disorders, and haemoglobinopathies and haemolytic anaemias in both 1990 and 2017. For males, the causes with the greatest age-standardised prevalence were oral disorders, headache disorders, and tuberculosis including latent tuberculosis infection in both 1990 and 2017. In terms of YLDs, low back pain, headache disorders, and dietary iron deficiency were the leading Level 3 causes of YLD counts in 1990, whereas low back pain, headache disorders, and depressive disorders were the leading causes in 2017 for both sexes combined. All-cause age-standardised YLD rates decreased by 3·9% (95% uncertainty interval [UI] 3·1-4·6) from 1990 to 2017; however, the all-age YLD rate increased by 7·2% (6·0-8·4) while the total sum of global YLDs increased from 562 million (421-723) to 853 million (642-1100). The increases for males and females were similar, with increases in all-age YLD rates of 7·9% (6·6-9·2) for males and 6·5% (5·4-7·7) for females. We found significant differences between males and females in terms of age-standardised prevalence estimates for multiple causes. The causes with the greatest relative differences between sexes in 2017 included substance use disorders (3018 cases [95% UI 2782-3252] per 100 000 in males vs 1400 [1279-1524] per 100 000 in females), transport injuries (3322 [3082-3583] vs 2336 [2154-2535]), and self-harm and interpersonal violence (3265 [2943-3630] vs 5643 [5057-6302]). Interpretation: Global all-cause age-standardised YLD rates have improved only slightly over a period spanning nearly three decades. However, the magnitude of the non-fatal disease burden has expanded globally, with increasing numbers of people who have a wide spectrum of conditions. A subset of conditions has remained globally pervasive since 1990, whereas other conditions have displayed more dynamic trends, with different ages, sexes, and geographies across the globe experiencing varying burdens and trends of health loss. This study emphasises how global improvements in premature mortality for select conditions have led to older populations with complex and potentially expensive diseases, yet also highlights global achievements in certain domains of disease and injury

Global, regional, and national age-sex-specific mortality and life expectancy, 1950-2017: a systematic analysis for the Global Burden of Disease Study 2017

Background: Assessments of age-specific mortality and life expectancy have been done by the UN Population Division, Department of Economics and Social Affairs (UNPOP), the United States Census Bureau, WHO, and as part of previous iterations of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD). Previous iterations of the GBD used population estimates from UNPOP, which were not derived in a way that was internally consistent with the estimates of the numbers of deaths in the GBD. The present iteration of the GBD, GBD 2017, improves on previous assessments and provides timely estimates of the mortality experience of populations globally. Methods: The GBD uses all available data to produce estimates of mortality rates between 1950 and 2017 for 23 age groups, both sexes, and 918 locations, including 195 countries and territories and subnational locations for 16 countries. Data used include vital registration systems, sample registration systems, household surveys (complete birth histories, summary birth histories, sibling histories), censuses (summary birth histories, household deaths), and Demographic Surveillance Sites. In total, this analysis used 8259 data sources. Estimates of the probability of death between birth and the age of 5 years and between ages 15 and 60 years are generated and then input into a model life table system to produce complete life tables for all locations and years. Fatal discontinuities and mortality due to HIV/AIDS are analysed separately and then incorporated into the estimation. We analyse the relationship between age-specific mortality and development status using the Socio-demographic Index, a composite measure based on fertility under the age of 25 years, education, and income. There are four main methodological improvements in GBD 2017 compared with GBD 2016: 622 additional data sources have been incorporated; new estimates of population, generated by the GBD study, are used; statistical methods used in different components of the analysis have been further standardised and improved; and the analysis has been extended backwards in time by two decades to start in 1950. Findings: Globally, 18·7% (95% uncertainty interval 18·4–19·0) of deaths were registered in 1950 and that proportion has been steadily increasing since, with 58·8% (58·2–59·3) of all deaths being registered in 2015. At the global level, between 1950 and 2017, life expectancy increased from 48·1 years (46·5–49·6) to 70·5 years (70·1–70·8) for men and from 52·9 years (51·7–54·0) to 75·6 years (75·3–75·9) for women. Despite this overall progress, there remains substantial variation in life expectancy at birth in 2017, which ranges from 49·1 years (46·5–51·7) for men in the Central African Republic to 87·6 years (86·9–88·1) among women in Singapore. The greatest progress across age groups was for children younger than 5 years; under-5 mortality dropped from 216·0 deaths (196·3–238·1) per 1000 livebirths in 1950 to 38·9 deaths (35·6–42·83) per 1000 livebirths in 2017, with huge reductions across countries. Nevertheless, there were still 5·4 million (5·2–5·6) deaths among children younger than 5 years in the world in 2017. Progress has been less pronounced and more variable for adults, especially for adult males, who had stagnant or increasing mortality rates in several countries. The gap between male and female life expectancy between 1950 and 2017, while relatively stable at the global level, shows distinctive patterns across super-regions and has consistently been the largest in central Europe, eastern Europe, and central Asia, and smallest in south Asia. Performance was also variable across countries and time in observed mortality rates compared with those expected on the basis of development. Interpretation: This analysis of age-sex-specific mortality shows that there are remarkably complex patterns in population mortality across countries. The findings of this study highlight global successes, such as the large decline in under-5 mortality, which reflects significant local, national, and global commitment and investment over several decades. However, they also bring attention to mortality patterns that are a cause for concern, particularly among adult men and, to a lesser extent, women, whose mortality rates have stagnated in many countries over the time period of this study, and in some cases are increasing

Biosurfactant-enhanced remediation of hydrocarbon contaminated mangrove swamp.

Crude biosurfactant extract produced by two microbial isolates, Pseudomonas mallei and Pseudomonas pseudomallei were used to enhance the biodegradation rates of petroleum hydrocarbon pollutants in amangrove swamp in Nigeria. Nutrient application in combination with biosurfactants showed very significant biodegradation rates of over 99% of the total petroleum hydrocarbon (TPH) which was removed after 3 weeksof exposure. Nutrient application alone without the biosurfactants only recorded about 53% remediation of TPH while biosurfactant application alone without nutrient supplement had about 84% of the TPH removedafter 3 weeks of exposure. The control plot did not show any remarkable biodegradation even after the 5 weeks exposure period, an indication that natural biodegradation without any form of enhancement can be a very slow process. The experimental data and the results obtained showed that the crude biosurfactant extract from P. mallei and P. pseudomallei were very effective in enhancing the biodegradation rates in the mangrove swamp especially when supplemented with nutrients.Keywords: Biodegradation, Petroleum hydrocarbons, Hydrocarbon utilizing bacteria

The anatomic pattern of fractures and dislocations among accident victims in Owerri, Nigeria

BACKGROUND: Some studies have described the pattern of limb fractures and dislocation in Nigeria. However, with recent increase in vehicle and motorbike transport, we aimed to describe the pattern tonote any differences from previous reports.METHODS: This was a retrospective study of all patients with accidental fractures and dislocations treated at the Federal Medical Centre Owerri between January 2000 and December 2003.RESULTS: A change in the major causative factors was observed as Road Traffic Accident (RTA) is now the major cause of injuries accounting for 72 percent of all cases. Fall from height was previouslythe major cause. In adults the tibia was the most frequently fractured bone accounting for 28.9 percent of all fractures while the femur was mostly involved in children accounting for 35 percent of all fractures. Again, different from previous reports lower limb fractures occurred in over 70 percent of cases while upper limb fractures accounted for only 20 percent.CONCLUSION: There is a major change in both the causative factors and pattern of fractures among accident victims in Nigeria

Presence of chaperones during pelvic examinations in southeast Nigeria: Women’s opinions, attitude, and preferences

Objectives: To assess the opinions, attitude, and preferences of Nigerian women to the presence of chaperones during pelvic examinations.Materials and Methods: A cross‑sectional survey of first time gynecology clinic attendees on their opinions, attitudes, and preferences with respect to the presence of chaperones during their pelvic examinations. The interview was conducted with the aid of semi‑structured, researcher‑administered questionnaires. Results: One hundred and nineteen (51.7%) of the respondents preferred female physicians for pelvic examination, 23 (10%) preferred male physicians and 88 (38.3%) had no gender preference. When the examining physician is a male, 124 (53.9%) respondents would like to have chaperones during pelvic examinations while 106 (46.1%) would not. Eighty‑three percent of respondents preferred nurse chaperones. Age, level of education, and parity did not have any significant relationship with the attitude of the respondents toward the presence of chaperones (P = 0.503, 0.525, and 0.605 respectively).Conclusions: We conclude that most southeastern Nigerian women would prefer their pelvic examinations to be done by a female physician or to be attended by a nurse chaperone if the examining physician is a male. We recommend a routine offer of chaperones during such examinations while respecting the patients’ right to refuse the offer.Keywords: Attitudes, chaperone, pelvic examination, preferences, southeast NigeriaNigerian Journal of Clinical Practice • Oct-Dec 2013 • Vol 16 • Issue

Estimation of Solar Radiation in South Eastern Nigeria

Knowledge of global solar radiation is of fundamental importance for all solar energy conversion systems. In this work is presented the Sayigh equation for estimating the global solar radiation, analyzing data from 1972 to 2004 in the Southeastern Nigeria using Umudike (lat. 5.29oN, long. 7.33oE) as a case study. The levels of the global solar radiation within the region was noted to range from 1.99 kWh to 6.75 kWh, showing that the method was in agreement with those of earlier authors in this area of research, indicating that the method could be used for reproducing signatures of global solar radiation in the region when actual measurements are not available. The results highlight the potential of using photovoltaic systems as viable energy option within the region. Keywords: Estimate, Photovoltaic systems, Sayigh, Solar Radiation, Southeastern Nigeria International Journal of Natural and Applied Sciences, 5(3): 223-228, 200

Sexual Behaviour and Practices Among Secondary School Adolescents in Anambra State, Nigeria

Background: According to the World Health Organization (WHO), adolescents are persons aged 10 to 19 years. Adolescence is the progression from appearance of sexual characteristics to sexual and reproductive maturity; development of adult mental processes and adult identity and a period of transition from total socio-economic dependence to relative independence. Their sexual behaviour is an issue of global public health concern. Objective: TThis study is to assess the sexual behaviour and practices among secondary school adolescents in Anambra State, Nigeria. Methods: A cross -sectional descriptive study of 384 inschool adolescents in Anambra State, Nigeria, selected using a multi stage random sampling technique was done. Data was collected using pre-tested, semi-structured self administered questionnaires. Data was analyzed with SPSS version 13 computer software. Results: One hundred and twenty (34.3%) out of 384 respondents have had their first sexual exposure and are sexually active. Seventy eight (65.0%) were males while 42 (35.0%) were females. The mean, modal and youngest ages of initiation into sexual activity were 15.08 + 0.2, 15+ 0.2, and 10+ 0.2 years respectively. About 49 (40.8%) have multiple sexual partners. Contraceptive awareness was 52.0%, while contraceptive uses at first and last sexual intercourse were 35 (29.2%) and 108 (75.0%) respectively. The most commonly used contraceptive methods were condom 90.0% (108) and pills 8.20% (10), while the most common reasons for having premarital sex were peer group pressure 50.0% (60) and monetary gains 27.5% (33). Conclusion: Risky sexual behaviour is high among this age group. Efforts to promote sexuality education and contraceptive awareness should be intensified. Key words: sexual behaviour, secondary schools, adolescents, Nigeria. Afrimedic Journal 2010; 1(2)22-2

Desire for prenatal gender disclosure among primigravidae in Enugu, Nigeria

Tochukwu C Okeke,1 Jamike O Enwereji,1 Onyemaechi S Okoro,1 Eric S Iferikigwe,1 Lawrence C Ikeako,2 Cyril C Ezenyeaku,2 Charles O Adiri1 1Department of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital, Enugu, Nigeria; 2Department of Obstetrics and Gynaecology, Anambra State University Teaching Hospital, Awka, Nigeria Background: Prenatal gender disclosure is a nonmedical fetal ultrasonography view, which is considered ethically unjustified but has continued to grow in demand due to pregnant women’s requests.Objective: The aim of this study was to determine the proportion of primigravidae who want prenatal gender disclosure and the reasons for it.Methods: This was a descriptive cross-sectional study of randomly selected primigravidae seen at Enugu Scan Centre. The women were randomly selected using a table of random numbers.Results: Ninety percent (225/250) of 250 primigravidae who fulfilled the criteria for inclusion in this study wanted to know the gender of their unborn baby, while 10% (25/250) declined gender disclosure. Furthermore, 62% (155/250) of primigravidae had preference for male children. There was statistically significant desire for male gender (P=0.0001). Statistically significant number of primigravidae who wanted gender disclosure did so to plan for the new baby (P=0.0001), and those that declined gender disclosure “leave it to the will of GOD” (P=0.014).Conclusion: Ninety percent of primigravidae wanted gender disclosure because of plans for the new baby, personal curiosity, partner and in-laws’ curiosity; moreover, some women wanted to test the accuracy of the findings at delivery and 62% of primigravidae had preference for male children. In view of these results, gender disclosure could be beneficial in this environment. Keywords: gender disclosure, prenatal ultrasonography, pregnant women, Enugu, Nigeri