Sexually transmitted infections among patients attending the General Practice Clinic, Wesley Guild Hospital, Ilesa, Nigeria

Background: Sexually transmitted infections (STIs) are among the most common infectious diseases in the world today. There are few reliable statistics on the true prevalence of STIs in developing countries, especially in the general practice setting, hence the need to determine the prevalence in each locality. With the scourge and pandemicity of human immunodeficiency virus (HIV) and the fact that STIs are recognised as independent risk factors for its transmission, determining the risk profiles for STIs has become paramount. The aim of this study was to describe the pattern of STIs among patients attending a Nigerian general practice (GP) clinic.Methods: This was a descriptive, cross-sectional, hospital-based study. Consenting patients were recruited serially between February and April 2006 until the sample size of 415 was reached. Subjects’ genital symptoms were considered according to the four common STI syndromes according to National AIDS/STD Control Programme guidelines. Results: The age range of the subjects was 15 to 95 years (mean 45.16 years, standard deviation 18.83 years, median 44 years). The median age at coitarche was 21 years while the median age at marriage was 25 years. The prevalence rates of current, past and lifetime STI were 18.8%, 22.4% and 32% respectively. Only 28 (6.8%) study subjects had laboratory evidence of STIs at the time of study. Previous sex with a commercial sex worker, previous history of STIs, premarital sex, first intercourse before or at 21 years of age and multiple sexual partners were significantly associated with STIs. Previous history of STIs was a strong predictor of current STI in this study while premarital sex and previous sex with a commercial sex worker were strong predictors of past STI. The frequency of HIV infection among subjects with STIs was more than double that of the control and a co-infection rate of 17.9% was found. Conclusions: The findings of this study indicate a high prevalence of STIs in the study community in association with prevailing high sexual risk behaviours, hence the need for reliable control programmes targeting the latter.Keywords: sexually transmitted infections; sexual behaviour; premarital sex; HIV; prevalence; general practic

The rate and cost of hospitalisation in children with sickle cell anaemia and its implications in a developing economy

Background: There is paucity of data on the cost and rate of hospitalization in children with sickle cell anaemia (SCA) in most developing nations.Objective: To estimate the rate and cost of hospitalization in children with SCA in Nigeria and evaluate the economic burdens on their families.Methods: The number and duration of hospitalizations; estimated aggregate family’s monthly income, cost of care and percentage of the mean annual income spent on hospitalization for each respondent were obtained using a structured questionnaire.Results: The mean age of the 73 children was 61.1(44.3) months; M:F was 1:1.6. They had 183 admissions (average of 2.5(1.9) admissions per child per year). The mean family monthly income was $250.37, while the average cost of care per hospitalization per subject was$132.67. The total cost of care during the year was $24,278.37. About one-third of the caregivers spent at least 10% of their estimated annual income as total cost of hospitalization.Conclusion: The rate and the cost of hospitalization for children with SCA and the percentage of income spent on hospitalization were too high in our environment. Government should strengthen the National Health Insurance Scheme and subsidise the cost of care to these children.Key words: Children, Cost, Hospitalization, Sickle Cell Anaemi

The Practice of Physical Exercise among the Staff of the International Institute of Tropical Agriculture, Ibadan, Nigeria.

Background: Physical exercise is important for good health. Moderate physical exercise for at least 30 minutes, five times a week is the minimum recommendation for adults. The objective of the study was to assess the level of physical exercise among the staff of an International research Institute in Ibadan, Nigeria.Methodology: This was a descriptive cross sectional study of 206 employees sampled proportional to the size of the IITA staff categories. After obtaining informed consent data on socio-demographic parameters, anthropometric measurements, knowledge of obesity, the practice of leisure and work-related exercise were obtained using a structured questionnaire. The data were analyzed using the Statistical Analysis System (SAS) version 9.2.Results: The mean age of the respondents was 37.0±10.8 years. Practice of leisure exercise was adequate, inadequate and nil in 16%, 54% and 30% respectively. The leisure exercises practiced most commonly were brisk walking, jogging and swimming in 42.2%, 20%, and 8.4% respectively. The survey revealed that 72%, 9% and 19% of the respondents were significantly active, moderately active and sedentary at work respectively. The majority, 61.5%, of the management staff were involved with sedentary jobs. The respondents with low formal education were more active at work compared to those with higher education, p = 0.005. Overall, 88.2% were physically active although about 45% of respondents were either overweight or obese and less than half had good knowledge of obesity.Conclusion: Public education is needed to improve physical activity and curb the menace of health problems associated with sedentary lifestyle.Keywords: Practice, Exercise, Leisure, Workrelated, Overweight, Obesity

Pattern of depression among patients in a Nigerian family practice population

Background: This study determines the pattern of depression among patients attending the Family Practice Clinic at Wesley Guild Hospital, Ilesa, Nigeria. Socio-demographic and clinical correlates associated with depression were identified. Methods: Two hundred and fifty (250) newly registered patients who attended the clinic between June and September 2005 were selected by the systematic random sampling method and studied. Relevant data were collected using a pre-tested interviewer- administered questionnaire that incorporated Zung\'s Depression Scale. Results: The age of the study subjects ranged from 16 to 84 years, with a mean age of 49.66 + 14.95 years. One hundred and forty-nine of the 250 subjects (59.6%) were found to have one form of depression or the other. Of these, one hundred and seven (42.8%) had mild depression, forty (16.0%) had moderate depression and only two (0.8%) had severe depression. Depression was found to be commoner in the age groups from 45 years and above, and there was a significant association between age and depression. There were 74 males and 176 females in the sample population, showing a male to female ratio of 1:2.4. Out of 149 depressed subjects, one hundred and four females (69.8%) had depression, while depression was present in 45 males (30.2%). Forty-seven (87.0%) of 54 subjects with no formal education had depression, while depression was found in 102 (52.0%) of the 196 educated subjects. Low educational status was significantly associated with depression in this study. Only two (0.8%) of the 250 subjects gave a positive family history of psychiatric illness, and these two subjects had mild to moderate depression. The proportion of depressed subjects who lived below the poverty level was significantly greater than that of non-depressed subjects. Substance use was also significantly more common among depressed subjects than the non-depressed group. Conclusion: The proportion of patients with depressive symptoms in family practice clinics is high, and it is highly correlated with socio-demographic factors and low socioeconomic status. Family physicians are hereby enjoined to pay greater attention to patients with these factors, as they are at increased risk of depression. In order to reduce the high proportion of depressive symptoms and its adverse impacts on patients seen in family practice clinics and in the community as a whole, there is a need for effective implementation of poverty-alleviation programmes and universal basic education. South African Family Practice Vol. 50 (2) 2008: pp. 63-63

Determinants of patient satisfaction with physician interaction: a cross-sectional survey at the Obafemi Awolowo University Health Centre, Ile-Ife, Nigeria

Background: Patient satisfaction influences the outcomes of the physician-patient encounter. Patient satisfaction has become a significant health care outcome and a useful indicator of the quality of care. The aim of the study was to assess the level of satisfaction among Obafemi Awolowo University Health Centre attendees in relation to physician-patient interaction and ascertain the relationship between the different aspects of physician-patient interaction, patient satisfaction and adherence intent.Methods: Demographic information and information on patients’ feelings about their doctors was collected from 300 consenting patients in a cross-sectional survey, using an adapted Medical Interview Satisfaction Scale self-administered questionnaire. Data were analysed with SPSS version 11. Logistic regression was conducted to identify the factors predicting patient satisfaction and adherence intent.Results: Of the 300 patients studied, 63.3% were generally satisfied with their physician-patient interaction. Nineteen per cent of patients were uncertain of their level of satisfaction. Patient satisfaction was positively associated with adherence intent. Patient confidence in the doctor and good communication skills and information provision on the part of the doctor predicted patient satisfaction, while patient confidence in the doctor and information provision by the doctor predicted adherence intent.Conclusions: A fifth of the study subjects were dissatisfied with their doctor-patient relationship. This study suggests the need for primary care physicians to be aware of the important place of interpersonal skills development in the application of medical knowledge and expertise in the provision of health care.Keywords: patient satisfaction; doctor-patient interaction; adherence intent; patient outcome

Birth Preparedness and Complication Readiness of Pregnant Women Attending the Three Levels of Health Facilities in Ife Central Local Government, Nigeria

Background: Birth preparedness and complication readiness (BP/CR) is a safe motherhood strategy which addresses delays that could increase the risk of dying in pregnancy, child birth and the immediate postpartum period. The strategy has not been effectively implemented in Nigeria hence maternal mortality remains unacceptably high. This study assessed the level of BP/CR and the determinants among antenatal clinic attendees in Ife Central Local Government Area of Nigeria. Subjects and Method: Antenatal women selected proportional to client caseloads from health facilities were studied using a semi-structured questionnaire. SPSS version 16 was used for data entry. Univariate, bivariate and multivariate analyses were performed. Results: Four hundred and one antenatal women were recruited. One hundred and fifty eight (39.3%) respondents knew no danger sign in pregnancy, childbirth and postpartum period. Only 24 (6.0%) had adequate knowledge of obstetric danger signs without prompting. Three hundred and forty (84.8%) and 312 (78.3%) women respectively had identified a birth place and begun saving money for delivery. As many as 304 (79.4%) made no arrangement for a blood donor. Majority of pregnant women (60-82%) took five other steps towards emergency readiness. By the study criteria, 140 (34.9%) and 265 (66.1%) were birth and complication prepared respectively. Conclusion: Majority of pregnant women had poor knowledge of obstetric danger signs. Women who booked late were moreJournal of Community Medicine & Primary Health vol 23 (1-2) 201

Age at menarche and the menstrual pattern of secondary school adolescents in northwest Ethiopia

<p>Abstract</p> <p>Background</p> <p>Population studies on normal and dysfunctional characteristics of menstrual cycles are scarce in Ethiopia. In addition variability in menarcheal age and menstrual characteristics are common. Knowledge on this variability is necessary for patient education and to guide clinical evaluation.</p> <p>Methods</p> <p>A cross sectional study was conducted in two small towns called Dabat and Kola Diba, northwest Ethiopia between April and May 2007. Systematic sampling method was used to select 622 school girls from two secondary schools. A pretested questionnaire prepared in Amharic was used to gather data. Selected girls cooperated in answering the questionnaire in their classrooms under the supervision of the research team. Only 612 of the adolescent females were included in the final analysis, of which 305 were from Koladiba High School and 307 from Dabat.</p> <p>Results</p> <p>The age of the study subjects ranges between 14 and 19 with a mean (standard deviation) of 16.9 ± 1 years. About 92.2% had attained menarche by the time the survey was conducted. The probit analysis of the <it>status quo </it>data yielded a median (CI) age at menarche of 14.8 (13.9-15.3) years. The average age at menarche by recall method was 15.8 ± 1 years. The mean age at menarche was 0.3 years younger for urban females compared with rural ones (p < 0.001). A cycle length between 21 and 35 days was observed in 70.3% of the girls. The mean duration of flow was 4 ± 1.3 days with a range of 2-7 days. The menstrual cycles were irregular in 42.8% of the subjects. The overall prevalence of dysmenorrhoea was 72% among these subjects. Premenstrual symptoms were present in 435 of the females (75.4%). The leading sources of menarcheal information to the adolescents were mothers (39.7%), followed by their friends (26.6%) and teachers (21.8%).</p> <p>Conclusion</p> <p>In this study age of menarche was found to be delayed which is even higher than the findings indicated similar studies conducted in Ethiopia and other African countries. A significant number of students complain of abnormal menstrual cycle, dysmenorrhoea and premenstrual symptoms which call for appropriate counselling and management.</p

'The girl with her period is the one to hang her head' Reflections on menstrual management among schoolgirls in rural Kenya

<p>Abstract</p> <p>Background</p> <p>The onset of menstruation is a landmark event in the life of a young woman. Yet the complications and challenges that can accompany such an event have been understudied, specifically in resource-poor settings. As interventions aim to improve female attendance in schools, it is important to explore how menstruation is perceived and navigated by girls in the school setting. This research conveys rural Kenyan schoolgirls' perceptions and practices related to menstruation</p> <p>Methods</p> <p>Data were collected at six rural schools in the Nyanza Province of Western Kenya. Using focus group discussions, in-depth interviews, and field notes from observations, researchers collected information from 48 primary schoolgirls and nine teachers. Systematic analysis began with a reading of transcripts and debriefing notes, followed by manual coding of the narratives.</p> <p>Results</p> <p>Focus group discussions became opportunities for girls to share thoughts on menstruation, instruct one another on management practices and advise one another on coping mechanisms. Girls expressed fear, shame, distraction and confusion as feelings associated with menstruation. These feelings are largely linked to a sense of embarrassment, concerns about being stigmatized by fellow students and, as teachers explained, a perception that the onset of menstruation signals the advent of a girl's sexual status. Among the many methods for managing their periods, girls most frequently said they folded, bunched up or sewed cloth, including cloth from shirts or dresses, scraps of old cloth, or strips of an old blanket. Cloth was reported to frequently leak and cause chafing, which made school attendance difficult particularly as the day progressed. Attitudes and practices of girls toward menstruation have been arranged into personal, environmental and behavioural factors.</p> <p>Conclusion</p> <p>Further research on menstrual management options that are practical, sustainable and culturally acceptable must be conducted to inform future programs and policies that aim to empower young girls as they transition into womanhood. Stakeholders working within this and similar contexts must consider systematic mechanisms to explain to young girls what menstruation is and how to manage it. Providing sanitary supplies or guiding girls on how to create supplies serve as critical components for future interventions.</p

Review of prostate cancer research in Nigeria

Prostate cancer (CaP) disparities in the black man calls for concerted research efforts. This review explores the trend and focus of CaP research activities in Nigeria, one of the ancestral nations for black men. It seeks to locate the place of the Nigerian research environment in the global progress on CaP disparities. Literature was reviewed mainly through a Pubmed search with the terms “prostate cancer”and “Nigeria”, as well as from internet and hard copies of journal pages