Breastfeeding practices of mothers of young children in Lagos, Nigeria

Objective: To determine the breastfeeding practices (prevalence, initiation and exclusivity) of mothers of young children in Lagos.Methods: This was a communitybased, cross-sectional study carried out in 2010 in two Local Government Areas of Lagos State. Structured, intervieweradministered questionnaires were administered on 600 mothers whom were selected by multistage sampling technique. Data was analyzed with Epi-info 2008.Results: The majority, (91.8%) of respondents breastfed their babies and 59.2% of them initiated breastfeeding within 1 hour of delivery. Eighty-two percent practiced exclusive breastfeeding (EBF) and 52.9% did for 6 months. Formal antenatal care (ANC) (OR 3.27, 95%CI 2.03- 5.29) and institutional delivery (OR 3.63, 95%CI 2.38-5.53) significantly increased early initiation of breastfeeding. These factors also significantly increased practice of EBF for 6 months; ANC- OR 2.54, 95%CI 1.49-4.35 and institutional delivery- OR 1.81, 95%CI 1.15-2.86. EBF for 6 months was significantly associated with lower parity (p=0.020) and higher maternal educational level. Those who had more than secondary education were 8 times more likely to practice EBF for 6 months than those with no formal education (OR 7.65, 95%CI 2.58- 24.28).Conclusion: Breastfeeding initiation and exclusivity for 6 months were inadequate. Promotion of good health-seeking behavior, maternal education and family planning are recommended in order to improve mothers’ breastfeeding practices and infant nutrition.Key words: Breastfeeding, healthseeking behavior, infant nutrition, maternal education, Nigeri

Infant feeding practices in the first six months of life among HIV positive mothers attending Teaching Hospitals in Lagos, Nigeria

Background: In the absence of any interventions, 5-20% of infants born to HIVinfected women will be infected through breastfeeding.Objectives: This study determined the pattern of infant feeding in the first six months among HIV positive women attending Teaching Hospitals in Lagos.Methods: It was a cross sectional descriptive study. All mothers who were registered between July and September 2012 in the ‘Prevention of mother to child transmission’ (PMTCT) clinic were interviewed (n=200). Pre-tested interviewer administered structured questionnaire was used to collect data and analysis was done using Epi-info software. Chi-square and Fischer exact tests were used to determine associations and p-value was set at 0.05.Results: Many of the respondents, 46.5% (n=93) were within the age range of 30 – 34. Exclusive formula feeding (EFF) was practiced by majority 73.5% (n=147) of the respondents, 18.5% (n=37) practiced Exclusive Breastfeeding (EBF) while 8% (n=16) practiced mixed feeding. Poor knowledge of infant feeding options and feeling that EBF was not enough in the first six months of life were associated with EFF (p = 0.04) and mixed feeding (p = 0.01) respectively.Conclusion: Although majority of the respondents practiced exclusive formula feeding, a sizeable proportion still practiced mixed feeding. Strengthening of counseling sessions at PMTCT clinic, encouragement of exclusive breastfeeding with antiretroviral drugs would help reduce the prevalence of mixed feeding and hence the risk of mother to child transmission of HIV.Key Words: Infant feedingpractices, Mothers, HIV Positiv

Malaria prevention in pregnancy among traditional birth attendants in rural Lagos, Nigeria

Background: Malaria accounts for approximately 1 million deaths annually and about 300,000 deaths in Nigeria alone. Pregnant women are particularly vulnerable to adverse consequences of malaria. The National Malaria Policy has adopted the use of Intermittent Preventive Treatment and Insecticide Treated Net for prevention of malaria in pregnant women. This study therefore determined the knowledge and practice of Traditional Birth Attendants regarding prevention of malaria in pregnancy in 2 rural Local Government Areas of Lagos State, Nigeria.Method: A cross sectional, descriptive study design was adopted and a total of 68 Traditional Birth Attendants were studied. Data was collected using a structured, interviewer administered questionnaire. Analysis was done with EPI info 2008 and WinPepi statistical softwares.Results: Age range of respondents was 20-75 years and the mean age was 46.4±8.7 years. Most (67.7%) of the respondents were not aware of Intermittent Preventive Treatment. However, most(81.8%) of the respondents who were aware got the information from the health workers, while only 31.6% of those that aware knew the right drugs to be used.Conclusion: Overall knowledge of malaria prevention with Intermittent Preventive Treatment in pregnancy was poor. The knowledge and practice of malaria prevention in pregnancy among the Traditional Birth Attendants in Ikorodu and Badagry Local Government Areas was poor. It is therefore recommended that a sensitization and training of the Traditional Birth Attendants be carried out since a good number of women still patronize them.Keywords: Malaria, Pregnancy, Traditional Birth, Attendants, Rural, Lagos, Nigeri

Knowledge and Attitude of Women to Exclusive Breastfeeding in Ikosi District of Ikosi - Isheri Local Government Area, Lagos State

Background: Infant malnutrition is a public health problem in developing countries.Objective: To determine the knowledge and attitude of women to exclusive breastfeeding in Ikosi district of Ikosi/Isheri Local Government Area.Methods: This was a descriptive cross sectional study which employed a multistage sampling technique to select four hundred female participants. Data was collected using structured interviewer-administered  questionnaires. A woman was included if she was within the reproductive age group and her last confinement was not more than five yearsResults: Awareness was high (98.3%) but only about one third (39%) had good knowledge of exclusive breastfeeding. Almost all respondents (98.8%) felt that breastfeeding was important. Majority (73.3%) believed that breast milk alone is sufficient for the baby in the first six months of life while more than half (61%) believed in the appropriateness ofbreastfeeding in public. Conclusion: Given that a relatively high proportion of women had positive attitudes despite the poor knowledge of exclusive breastfeeding, public enlightenment and continued health education especially in the antenatalclinics are pertinent to maternal and child care to attain the  recommendation of 90% practice in developing countries.Keywords: Knowledge, attitude, exclusive breastfeedin

Neonatal Jaundice: A Survey of Perinatal Correlates among Mothers of Infants Attending Immunization Clinic in Surulere Local Government Area

Neonatal jaundice (NNJ) is a major public health problem worldwide and is present in 50-60% of full term and 80% of preterm newborns. It contributes to the high neonatal morbidity and mortality in sub-Saharan Africa, Asia and Latin America. Various studies in Lagos have reported higher rates compared to other parts of Nigeria and the developing world. This study set out to determine the perinatal correlates of neonatal jaundice among mothers of infants attending immunization clinics in Surulere local government area (LGA) of Lagos State. This was a cross-sectional descriptive study among mothers attending selected immunization clinics in Surulere local government area. Multistage sampling was used to select four immunization clinics from three wards in the LGA. Using astructured interviewer-administered questionnaire, data were obtained from 394 mothers on their socio-demographic characteristics, ANC and birth history, history of neonatal jaundice and how it was managed. Data obtained was analyzed using IBMSPSS and presented as frequencies and percentages Associations were tested statistically using Chisquare at a significance level of p<0.05. The mean age of mothers was 29.3+5 years. Majority (86.3%)of mothers received antenatal care and delivered in hospitals, 86.3% and 83.3% respectively. Almost half (47.0%) had booked in the first trimester, 36.5% reported febrile illness during pregnancy. Post-birth, 92 mothers (23.4%) were discharged within 6 hours of delivery and 52.2% of these mothers were discharged within 1 hour of delivery. Less than a third (28.7%) initiated breastfeeding within 1 hour, 37.3% within 6 hours and 24.4% did not initiate breastfeeding for >12 hours. Seventy-nine mothers (20.1%) noticed NNJ; 31.6% in <24 hours, 39.2% in 24-72 hours and 29.1% after 72 hours. Almost all mothers (97.7%) were still breastfeeding and 63.4% reported exclusively breastfeeding their babies. History of NNJ in previous baby and illness during pregnancy were significantly associated with NNJ. The proportion of babies in whom the mothers reported neonatal jaundice was19.5%. NNJ was significantly associated with illness during pregnancy and previous history of NNJ. The authors recommend strengthening the implementation of postnatal examination of newborns prior to discharge and early return for re-examination of those newborns discharged earlier than 72 hours of birth.Key words: Neonatal jaundice, perinatal correlates, antenatal care practices, delivery practices and Infant feedin

BODY IMAGE DISSATISFACTION, DISORDERED EATING ATTITUDES AND NUTRITIONAL STATUS AMONG FEMALE UNDERGRADUATE STUDENTS IN LAGOS, NIGERIA

Body image dissatisfaction (BID) is associated with the development of disordered eating attitudes, which can eventually lead to eating disorders. This study was conducted to assess body image dissatisfaction, disordered eating attitudes and nutritional status of female undergraduate students in Lagos as a baseline for an online intervention study. It was a descriptive cross-sectional study. Multistage sampling technique was employed to select 1009 from the intervention group (University of Lagos) and 1005 students from the control group (Lagos State University). Data were collected using semi-structured self-administered questionnaire. Anthropometric measurements were taken following standard procedures. Perceived body size was determined by using the Pulver’s Figure Rating Scale Silhouette. Disordered eating was assessed using the Eating Attitudes Test (EAT-26). Data were analysed using a statistical program IBM SPSS (version 25) with a significant level set at p ≤0.05. Chi-squared tests were used to detect differences in proportions for categorical variables. Fisher’s exact test was used where cell sizes were less than five, independent-samples t-tests were used to test for differences in the means of continuous variables. The mean age of the students was 20.7±2.0 years for intervention and 20.9±2.2 years control groups. The prevalence of body image dissatisfaction was 57.0% and 60.6% among intervention and control groups, respectively. The prevalence of underweight, overweight and obesity were 13.5%, 18.3% and 7.2%, respectively for the intervention group and 13.3%, 19.5% and 8.0% respectively for the control group. The prevalence of disordered eating attitudes was 5.2% and 4.7% for intervention and control groups, respectively. Only the control group demonstrated a significant positive association between nutritional status and body image dissatisfaction as well as body image dissatisfaction and disordered eating. There was no statistically significant difference in nutritional status, body image dissatisfaction and disordered eating attitudes among the students in the intervention and control groups. Although the prevalence of BID and overweight/obesity was high, the rate of disordered eating was low. The study showed a significant positive association between BMI and body image dissatisfaction as well as body image dissatisfaction and disordered eating among undergraduates in Lagos. Body Image dissatisfaction, overweight/obesity are higher than reported in the past although the prevalence of disordered eating was low among university undergraduates in Lagos. Interventions that address these three parameters are needed among university undergraduates to prevent increase in disordered eating, eating disorders and other related health consequences

BODY IMAGE DISSATISFACTION, DISORDERED EATING ATTITUDES AND NUTRITIONAL STATUS AMONG FEMALE UNDERGRADUATE STUDENTS IN LAGOS, NIGERIA

Body image dissatisfaction (BID) is associated with the development of disordered eating attitudes, which can eventually lead to eating disorders. This study was conducted to assess body image dissatisfaction, disordered eating attitudes and nutritional status of female undergraduate students in Lagos as a baseline for an online intervention study. It was a descriptive cross-sectional study. Multistage sampling technique was employed to select 1009 from the intervention group (University of Lagos) and 1005 students from the control group (Lagos State University). Data were collected using semi-structured self-administered questionnaire. Anthropometric measurements were taken following standard procedures. Perceived body size was determined by using the Pulver’s Figure Rating Scale Silhouette. Disordered eating was assessed using the Eating Attitudes Test (EAT-26). Data were analysed using a statistical program IBM SPSS (version 25) with a significant level set at p ≤0.05. Chi-squared tests were used to detect differences in proportions for categorical variables. Fisher’s exact test was used where cell sizes were less than five, independent-samples t-tests were used to test for differences in the means of continuous variables. The mean age of the students was 20.7±2.0 years for intervention and 20.9±2.2 years control groups. The prevalence of body image dissatisfaction was 57.0% and 60.6% among intervention and control groups, respectively. The prevalence of underweight, overweight and obesity were 13.5%, 18.3% and 7.2%, respectively for the intervention group and 13.3%, 19.5% and 8.0% respectively for the control group. The prevalence of disordered eating attitudes was 5.2% and 4.7% for intervention and control groups, respectively. Only the control group demonstrated a significant positive association between nutritional status and body image dissatisfaction as well as body image dissatisfaction and disordered eating. There was no statistically significant difference in nutritional status, body image dissatisfaction and disordered eating attitudes among the students in the intervention and control groups. Although the prevalence of BID and overweight/obesity was high, the rate of disordered eating was low. The study showed a significant positive association between BMI and body image dissatisfaction as well as body image dissatisfaction and disordered eating among undergraduates in Lagos. Body Image dissatisfaction, overweight/obesity are higher than reported in the past although the prevalence of disordered eating was low among university undergraduates in Lagos. Interventions that address these three parameters are needed among university undergraduates to prevent increase in disordered eating, eating disorders and other related health consequences

Anaemia Prevention In Pregnancy Among Antenatal Clinic Attendees In A General Hospital In Lagos

Background: Anemia is the world's second leading cause of disability and thus one of the most serious global public health problems. The World Health Organization (WHO) estimates that an average of 56% of pregnant women in developing countries, are anaemic.Objectives: This study was conducted to determine the knowledge, attitude and practices of prevention of anaemia in pregnancy amongst pregnant women attending the Antenatal Clinic at Ifako-Ijaiye General Hospital.Methods: The design was cross-sectional descriptive study. Simple random sampling method was used to select two hundred and twenty respondents (220). A pretested, structured, interviewer administered questionnaires were used for data collection.Results: Majority (95%) of the respondents was aware of anemia in pregnancy but the mean knowledge score was 56.5%. Less than half (46.3%) of the respondents thought that contraceptives could help prevent anemia in pregnancy by reducing closely spaced pregnancies. Only 31.8% were compliant with the use of iron supplements. About one third (33.2%) didn't combine drinking tea with meals while 47.3% of the respondents didn't use iron supplements with milk products.Conclusion: The study showed that most of the respondents had a moderate level of knowledge, and positive attitude towards contraceptive use but a high proportion were not compliant with the daily use of ironsupplements. It is recommended that health education of women as well as close family members should be reinforced to improve the compliance with supplements.Key words: Knowledge, attitude, practices, anaemia, pregnancy, antenatal clinic, Lagos, Nigeria

Anthropometrically determined nutritional status of children in public and private primary schools in Lagos, Nigeria

Background: Under-nutrition remains high while overweight/obesity are on the rise in developing countries. Little is known about the differences in the prevalence of malnutrition among public and private primary school children in urban areas of Lagos, Nigeria. This study determined and compared the nutritional status of children in public and private primary schools in an urban area of Lagos, Nigeria.Methods: A cross sectional study was conducted among public and private primary school children in an urban town in Lagos, Nigeria using multi-stage sampling technique to select 206 pupils. A structured interviewer administered questionnaire was used to obtain information on sociodemographic characteristics while anthropometric measures were obtained and compared to standards using WHO AnthroPlus, to determine the nutritional status.Results: The prevalence of underweight (WAZ <-2SD) in the public primary schools, 6.8% (n=7) was higher than in the private schools, 1.9% (n=2) but the difference was not statistically significant. (p = 0.085). However, the higher prevalence of stunting (HAZ <-2SD) in public (20.4% (n=24) compared to private schools 3.9% (n=4) was statistically significant (P<0.000). The prevalence of overweight and obesity were significantly higher among respondents in private schools (8.7% and 4.9%) compared to those in public schools (0.0% and 1.0% ) (p=0.0003).Conclusions: Stunting was higher in the public schools, while obesity and overweight were higher in the private schools. Appropriate feeding from birth should be promoted to prevent under-nutrition among children in public schools and overweight/obesity among children in private schools. Keywords: Anthropometry; Children; Nutrition; Stuntin

Knowledge, attitude and practice of drug abuse among public secondary school students in Lagos, Nigeria

Background: The use of alcohol, tobacco and other substances constitutes one of the most important risk–taking behaviour among adolescents and young adults in secondary schools. This study was conducted to determine the knowledge, attitude and practices of secondary school students in Lagos, Nigeria concerning drug abuse. Methods: This was a descriptive cross sectional study which employed a multistage sampling method to select 400 participants. Data was collected using semi-structured pre-tested interviewer-administered questionnaires. Results The mean age was 13.8±1.9 years. More than 50% knew the meaning of drug abuse, the dangers in using drugs wrongly and the legal status of drug abuse. Many of the respondents had positive attitudes to using illegal drugs (58.5%). The drugs mostly used by the students were coffee and analgesics while Indian hemp, alcohol and cigarettes were abused sparingly. Conclusion: The level of knowledge of the students concerning drug abuse was fair, many of the respondents had positive attitudes to using illegal drugs and the drugs mostly used were the socially acceptable ones; but they are likely to lead to the use of stronger ones later in life. Drug and alcohol education should therefore be strengthened in schools through the curriculum and drug abuse days. Legislation guiding sales of drugs should beenforced, the public should be educated and the sale of drugs monitored.Keywords: Attitude, Drug Abuse, Knowledge, Students.High Med Res J 2013;13:44-4