Trends in the prevalence of human immunodeficiency virus among pregnant women in Keffi, north central Nigeria.

Background: Infection with the Human Immunodeficiency Virus remains a major global health challenge. Nigeria is committed to reaching universal access targets as well as meeting the MDG goal of halting and reversing the spread of the HIV epidemic by 2015. The Nigerian National HIV Sero-prevalence Sentinel Survey has recorded a decreasing prevalence since 2008. Federal Medical Centre Keffi has also made prudent strides to help attain this national target.Objective: To determine the trends in the prevalence of HIV infection among antenatal clinic attendees at Federal Medical Centre, Keffi, North Central Nigeria.Method: This is a cross-sectional study of women attending antenatal clinic at the Federal Medical Centre, Keffi, Nasarawa State, North Central Nigeria from 1st January 2007 to 31st December 2013.Results: A total of 13,661 clients booked for ante-natal care at Federal Medical Centre, Keffi during the study period. All were counseled and tested for HIV with an opt - out rate of 0.0%. Nine hundred and fifty – three clients tested positive giving an overall prevalence of 7.0%. The number of patients tested increased by the years from 1018 in 2007 to 2886 in 2013. The prevalence of HIV infection decreased over the years from 17.8% in 2007 to 2.0% in 2013.Conclusion: This study has shown a consistently decreasing prevalence in HIV infection among pregnant women despite a persistent increase in the total number of antenatal attendance over the years. There was also no opt out of HIV testing after the counseling. To maintain a decreasing prevalence, we recommend concerted efforts aimed at decreasing the incidence of HIV infection while striving to increase access to HIV/AIDS treatment, care and support.Key words: Trends, HIV, Pregnant women, Keffi Nigeri

Radiographic Evaluation of Age and Gender Related Cortical Bone Thinning Using The Metacarpal Index Method: A Lagos Based Population Study

A retrospective study to evaluate age and gender relatedcortical bone thinning using the metacarpal index (MCI)method was performed. Study sought to evaluate the effect ofage and gender on metacarpal index. A randomized collectionof 850 (males 436, females 414) dorsi-plantar radiographs ofthe left hand performed from 2003-2005 and accompanyingrequest forms was carried out. The width of the cortex of thesecond metacarpal and shaft was measured and used tocalculate the metacarpal index. Values were compared acrossage ranges and sex. Result showed a gradual increase in MCIfor both sexes from 20-40 years (peak MCI 57.4±2 and52.8±02 for males and females respectively at 40 years). Alinear decrease after the 5th decade of life was also observed.Males showed a higher MCI than females at all ages withmean values of 53.3±3.2 and 46.21±3.9 respectively. A morerapid decrease in MCI was observed in females than males

Cervical Cancer Screening by Female Workers in South East Nigeria

Cervical cancer is one of the commonest female cancers especially in developing countries. Efforts towards its prevention worldwide have focused on screening women at risk of disease using Pap smears and treating pre-cancerous lesions. A good knowledge and understanding of the level of practice of cervical cancer screening among female workers in south east Nigeria will help in creating population-specific healthcare programs and interventions aimed at improving women’s health. OBJECTIVES: To determine the perception and practice of cervical cancer screening among female workers in south east Nigeria as well as ascertain the influence of age, educational status and marital status on the practice of cervical cancer screening among this group. METHOD: A cross-sectional descriptive study carried out among female workers in Nnewi who were selected using multi-stage approach between December 2007 and January 2008. Tests of statistical significance were done using chi square test at 95% confidence interval. RESULTS A total of 172 females responded. The mean age was 29.7 ± 8.8 years and the ages ranged from 15 to 65 years. One hundred and twenty-three respondents (71.5%) knew about cervical cancer screening. Only 12 (9.8%) of the respondents who were aware of Pap smear had done the test, of which 9 (75.0%) had disease detected. There was no statistically significant association between educational level, age andmarital status respectively and the practice of cervical cancer screening. CONCLUSION: There is avery lowlevel of practice of cervical cancer screening in this group. Educational level, age and marital status were found not to affect the practice of cervical cancer screening. Key Words: Cervical cancer, workers, practice, Nigeri

Weekend versus weekday hospital deaths: Analysis of in‑patient data in a Nigerian tertiary healthcare center

Aim: This study aims at comparing weekday deaths to weekend deaths of in‑patients of a tertiary hospital in Nigeria.Materials and Methods: This is a 10‑year retrospective survey conducted at the Nnamdi Azikiwe University Teaching Hospital in which the death records of the hospital were accessed from the various wards and health records department to extract relevant data pertaining to the time of hospital death. Tests of statistical significance were done using Chi‑square test at 95% confidence intervals.Results: A total of 3934 deaths were recorded during the period of study. The ages ranged from a few hours to 94 years with a mean age of 38.5 years. The male to female ratio was 1.2:1. An average of 547 weekend deaths and 568 weekday deaths were recorded, giving a ratio of 0.96:1. A ratio of weekend to weekday death rate of 0.99:1 and 0.93:1 for the males and females, respectively was noted. The labor ward, followed by the intensive care unit (ICU) had the highest weekend to weekday death ratio of 1.72:1 (P = 0.0461) and 1.41:1 (P = 0.1440), respectively. Weekend deaths were less in the other wards, with the gynaecological ward having the least ratio of 0.63:1 (P = 0.7360).Conclusion: The rate of hospital deaths was generally found not to vary significantly over the weekends and weekdays in the hospital except for the labor ward which had significantly higher weekend to weekday death rates of 1.72:1. There is therefore need for confidential enquiry into the causes of hospital deaths, especially in the labor ward, in order to identify and prevent avoidable deaths.Keywords: Hospital deaths, in‑patients, weekend deathsNigerian Journal of Clinical Practice • Oct-Dec 2013 • Vol 16 • Issue

Pain Relief in Postabortion Care Practiced by Healthcare Professionals in South Eastern Nigeria

Background: Postabortion care (PAC) is aimed at reducing maternal morbidity and mortality resulting from the incomplete abortion and abortion complications. The use of analgesia is an integral part of high quality PAC. Knowledge of the pattern of use of analgesia in PAC by healthcare professionals would help in planning group specific training programs for more effective PAC. Aim: This study is aimed at assessing the use of analgesia in PAC among healthcare professionals in South Eastern Nigeria.Subjects and Methods: This is a cross‑sectional questionnaire‑based survey carried out among healthcare professionals in Anambra State, Nigeria between June 1 and September 30, 2006.  Participants were chosen using a multistage sampling technique. Pretested questionnaires assessing the practice of postabortion counseling were then administered. The data were analyzed using SPSSversion 20.0 software. Frequencies were within 95% confidence limits.Results: A total of 437 health professionals were included in the study. The mean age was 38.2 (10.4) years. Formal PAC training influenced the use of analgesia positively (P < 0.001). The use of analgesia in PAC was also significantly higher among professionals working in tertiary healthcare center and private specialist hospitals when compared with other facilities (P = 0.02). In general complications were more when analgesia was not employed. Older professionals were more likely to employ pain relief in PAC (P = 0.01). Furthermore, doctors were significantly more likely to employ pain relief in PAC when compared to nurses (P = 0.001).Conclusion: This study revealed a low level of use of analgesia in PAC among the healthcare  professionals. It also demonstrated a significant association between formal PAC training and use ofanalgesia in PAC. It is, therefore, recommended that increased PAC training and re‑training activities with emphasis on the need for analgesia should be conducted for healthcare professionals to improve the quality of PAC received by clients.KEY WORDS: Pain relief, post abortion care, Nigeri

Perception and Practice of Periodic Medical Checkup by Traders in South East Nigeria

BACKGROUND Periodic medical checkup helps improve life expectancy. Traders are a major economically active population in south eastern Nigeria and are expected to benefit from periodic medical checkup. A good knowledge and understanding of the prevailing health knowledge, attitude and preventive health behaviour of these traders is essential for creating population-specific health programs. OBJECTIVES To determine the knowledge, attitude and practice of periodic medical checkup by traders in South east Nigeria, as well as the influence of age, gender and educational status on its practice in this group. METHODS: A questionnaire- based descriptive study carried out among traders in Nnewi, South east Nigeria, who were selected randomly between September and October 2010. A total of 323 traders responded, 252 males (78.0%) and 71(22.0%)females. Themeanagewas 31.9± 10 years and the ages ranged from15 to 65 years withmajority(49.2%) between 20-29 years. Majority (61.0%) had secondary school education and 1.2% had post secondary school education. About 74.9% were aware of periodic medical checkup; all females and 67.9% of males. Major source of information was through friends (61.2%), then mass media(18.2%). The commonest known type of medical checkup was general examination (60.7%), then blood pressure measurement (55.4%). About 63.8% feel everybody needs medical checkup. Most (85.5%) feel medical checkups can improve their work efficiency. Only 29.4% of males and 39.4% of females practice periodic medical checkup. Age, gender and educational status were found not to affect practice of periodic medical checkup significantly. CONCLUSION: This study revealed a high level of awareness of periodic medical checkup, but a very low level of practice among this group. Effort should be made by health agencies to educate traders on the various types of medical check up, their indications and benefits as well as its practice encouraged. Keywords: Periodic medical checkup, traders,Nigeria

Inter-Pregnancy Interval (IPI): What Is The Ideal?

No Abstract Available Afrimedic Journal 2011;2(1):36-3

Knowledge of Cervical Cancer and its Screening Amongst Female Workers In Nnewi, Nigeria

Background: Cervical cancer is an important women's reproductive health problem, especially in developing countries. Efforts towards its prevention worldwide have focused on screening women at risk of disease using Pap smears and treating pre-cancerous lesions. A good knowledge and understanding of the level of awareness of cervical cancer and its screening among female workers in Nnewi will help in creating population-specific health programs. Objectives: This is to determine the awareness of cervical cancer screening among female workers in Nnewi as well as ascertain the influence of age, educational status and marital status on the awareness of cervical cancer screening among this group. Methods: A cross-sectional descriptive study carried out among female workers in Nnewi who were selected using multi-stage approach between December, 2007 and January, 2008. Results: A total of 172 females responded. The mean age was 29.7 ± 8.8 years and the ages ranged from 15 to 65 years. A total of 146 respondents (84.9%) were aware of cervical cancer. One hundred and twenty-three respondents (71.5%) knew about the Pap smear screening test. Educational level was found to significantly affect the awareness of cervical cancer and Pap smear screening test. Age and marital status were found not to affect awareness of cervical cancer and Pap smear screening test. Conclusion: There is relatively high level of awareness of cervical cancer and Pap smear test among this group. Educational status was found to significantly influence the level of awareness of cervical cancer and its screening. Key words: cervical cancer, knowledge, screening. Afrimedic Journal 2010; 1(1): 31-3

The Rate of Caesarean Section in Nnewi, Nigeria: A 10-year Review

Background: There is widespread public and professional concern about the increasing proportion of births by caesarean section (c/s). Objectives: This study is to determine the c/s rate, the indications and the reasons for the high rate. Methods: The obstetric records of all caesarean deliveries that occurred at Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, South-Eastern Nigeria, between 1st January, 1999 and 31st December, 2008 were reviewed retrospectively. Results: Of the 6,015 deliveries, 1,114 were by C/S giving an overall rate of 18.5%. Caesarian birth rose from approximately 1 in 7 deliveries in 1999 to 1 in 4 deliveries in 2008 and this was 2 statistically significant (x =20.75; df=1;

Perception and Practice of Emergency Contraception by Females of Reproductive Age Group in a Tertiary Healthcare Institution in South Eastern Nigeria

Background: Unsafe abortion continues to contribute significantly to maternal morbidity and mortality especially in developing countries. Adequate knowledge and correct use of Emergency Contraception (EC) will serve as a backup for regular contraception. This will help to reduce unwanted pregnancies and the consequent unsafe abortion. Objective: This was to determine the knowledge, attitude and use of EC by the females of reproductive age group in Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi. The findings will help in making recommendations on the use of EC. Methods: This was a cross-sectional survey, using self administered questionnaire among female workers and students in NAUTH, Nnewi aged 15-49 years. Result: A survey of 450 females of reproductive age in NAUTH Nnewi showed that the concept of Emergency Contraception (EC) was well known. The majority of the respondents 330 (73.3%) were aware of emergency contraception. However, only 120(26.7%) had used one form of emergency contraception or the other. Among the various methods of EC mentioned by the users, progesterone only pills (postinor) 60 (50.0%) and combined oral contraceptive pills 30 (25.0%) were the commonest types used by the respondents. Few respondents 25 (20.8%) had misused other form of agents and methods for EC. The respondents reported varying circumstances under which EC was indicated but the majority cited miscalculation of rhythm method, 107 (32.3%) and condom breakage during coitus 76 (22.7%). The most common source of information about EC was from friends, 128 (40.0%) while patent medicine store was the commonest source of procurement 60 (50.0%). Most, 180 (40.0%) of the respondents felt that EC should not be used mainly on religious grounds. Conclusion: The knowledge of EC was high among the females of reproductive age in NAUTH but the utilization was poor. Training and retraining of health workers and public health education in hospitals, schools and religious groups are necessary to develop a positive attitude and correct use of EC. Key words: perception, practice, emergency contraception Afrimedic Journal 2010; 1(2): 15-2