Call hour maxillofacial emergencies presenting to a Nigerian teaching hospital

Objective: The study was undertaken to document the pattern of maxillofacial emergencies presenting to the accident and emergency unit of the Obafemi Awolowo University Teaching hospital, Ile-Ife between January 2001 and December 2002. Method: The patients' demographics, the time of presentation, duration of emergency and mode of arrival was documented. Injuries of the oro-facial soft and hard tissues, injuries in other parts of the body, the investigations carried out and the management instituted was also recorded. Results: 106 patients representing 1.3% of all the Accident and Emergency admissions were seen by the maxillofacial unit. Males predominated (90 males against 16 females), mean age was 31.3 years, students (28%) were the most frequently encountered and weekends recorded the highest number of emergencies (50 patients or 47.2%). Trauma was the main reason for presentation (102 patients or 96.2%) and commercial vehicles were the commonest means of transportation to the hospital in 63 patients (59.4%). About a third of the subjects (31 or 36.1%) presented within the first hour, and the soft tissues of the midface were most often involved. The mandible was the most commonly fractured bone (20 patients or 19.6%) and limb injuries were the most commonly observed injury in other parts of the body (43 patients or 42.2%). Sixty-eight out of the 88 patients who required a surgical procedure were treated in the accident and emergency unit and 49 patients (46.2%) were admitted into the wards. The outcome was not significantly affected by the time or mode of presentation. Conclusions: There is a need for an oral and maxillofacial trauma registry at different locations in the country to ensure a long-term data collection for the development and evaluation of preventive measures. Key Words: Maxillofacial trauma; emergencies. African Journal of Oral Health Vol.1(1) 2004: 17-2

Adolescents and HIV-related behaviour in Nigeria: does knowledge of HIV/AIDS promote protective sexual behaviour among sexually active adolescents?

HIV/AIDS prevalence among Nigerian youth remains one of the highest in the world. Although studies confirmed a high knowledge of HIV among Nigerian youth, there is a lag in linking HIV/AIDS knowledge with protective sexual behaviour. The study utilized data from the Nigeria 2007 National HIV/AIDS and Reproductive Health Survey (NARHS). Analysis was on 865 sexually active adolescents. About 75% of adolescents had good knowledge of HIV/AIDS. Logistic regression models showed that HIV knowledge was significant predictor of non-use of condom (OR=2.34; p=0.041) and accepting gifts for sex (OR=2.02 p=0.043) among male, and predictor of multiple sexual partners (OR=1.30; p=0.023) among females. Regardless of HIV knowledge, higher education, older age at first sex, higher wealth index and urban residency are significant predictors of engagement in non-protective sexual behaviour. The study concludes that high knowledge of HIV/AIDS is not statistically significant in HIV protective attitudes among adolescents

Medical and dental students’ attitude and practice of prevention strategies against hepatitis B virus infection in a Nigerian university

Introduction: Medical and dental students are a high-risk group for hepatitis B virus (HBV) infection which is an occupational hazard for them and a leading cause of death globally. Prevention strategies include vaccination and observance of standard precaution. However, available reports claim utilization of the prevention strategies is low. This study evaluated the attitude of the students towards HBV vaccine and cross-infection practices. Methods: This study was a cross-sectional study carried out at the College of Health Sciences, Obafemi Awolowo University, Nigeria. Using the convenience sampling method, anonymous self-administered questionnaires were distributed to the first 120 participants that volunteered to participate in the study. Data analysis was done using IBM's Statistical Package (SPSS) version 20 software. Statistical level of significance was set at p < 0.05.Results: Over eighty percent (83.2%) of the participants had at least a dose of the HBV vaccine while 79.65% completed the three doses. Majority (94.7%) of the students that did not receive the vaccine cited their busy schedule as the reason for their failure to be vaccinated. Taking every patient as a contagious disease risk (86.5%), washing hands after contact with patients' body fluids (82.1%) and wearing gloves before touching mucous membranes and non-intact skin (74.1%) were the most practiced universal standard precaution items.Conclusion: The uptake rate of HBV vaccination and practice of standard precaution among the students are commendable. However, there is need for improvement considering the level of HBV infection in Nigeria. Key words: Medical and dental students, hepatitis B vaccine, universal precaution, Nigeri

Influence of Family Size, Household Food Security Status, and Child Care Practices on the Nutritional Status of Under-five Children in Ile-Ife, Nigeria

Fertility pattern and reproductive behaviours affect infant death in Nigeria. Household food insecurity and poor care practices also place children at risk of morbidity and mortality. The objectives of this study were to assess the influence of family size, household food security status, and child care practices on the nutritional status of under-five children in Ile-Ife, Nigeria. The study employed a descriptive cross-sectional design. A semi-structured questionnaire was used to collect data from 423 mothers of under-five children and their children in the households selected through multistagesampling methods. Food-insecure households were five times more likely than secure households to have wasted children (crude OR=5.707, 95 percent CI=1.31-24.85). Children with less educated mothers were significantly more likely to be stunted. The prevalence of food insecurity among households in Ile-Ife was high. Households with food insecurity and less educated mothers were more likely to have malnourished children (Afr J Reprod Health 2010; 14[4]: 123-132)

Women’s perceptions and reflections of male partners and couple dynamics in family planning adoption in selected urban slums in Nigeria: a qualitative exploration

BACKGROUND: Nigeria is one of the countries where significant progress has not been recorded in contraceptive uptake despite decades of family planning programs while there are indications that slum dwellers may differ significantly from other urban dwellers in their sexual and reproductive behavior, including family planning uptake. This study therefore examined local notions regarding male partners’ involvement in family planning (FP) adoption by women in two selected urban slums areas in Nigeria – Ibadan (Southwest region) and Kaduna (Northwest region). Specifically, the study investigated women’s narratives about FP, perceived barriers from male partners regarding FP adoption by the women and how women negotiate male partners' cooperation for FP use. METHODS: Sixteen FGD sessions were conducted with selected groups of men and women, stratified by sex, age group, and FP experience using a vignette to generate discussions. Sessions were facilitated by experienced social scientists and audio-taped, with note-taker also present. The transcribed data were analyzed with Atlas.ti software version 7. Inductive approach was employed to analyze the data. Reasons given for FP attitudes and use are presented in a network format while critical discourse analysis was also used in generating relevant tables. RESULTS: The finding shows that women in the selected communities expressed desire for FP adoption. Three main reasons largely accounted for the desire to use FP: perceived need to space childbirth, family’s financial condition and the potential adverse effect of high fertility on the woman’s health. Male partners’ support for the use of FP by women was perceived to be low, which is due to misconceptions about FP and traditional pro-natalistic beliefs and tendencies. Mechanisms by which women negotiate their male-partner’s cooperation for FP adoption include seeking the support of the partner’s significant others and advice from older women. CONCLUSION: To significantly improve family planning adoption rates among urban slum dwellers in Nigeria, there is the need to specifically and specially target men alongside their female partners as well as other stakeholders who have significant influences at family and community level. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/1471-2458-14-869) contains supplementary material, which is available to authorized users

Adequacy of Technical Facilities for Maternal Health Care Delivery in Public Secondary and Tertiary Facilities in Osun State, Nigeria

Nigeria has one of the highest maternal mortalities and morbidities in the world, and the need to address these challenges continues to engage the attention of relevant stakeholders but very little attention has focused on technological resources within the maternal health research agenda. This study aims to identify and determine the adequacy of the key equipment for emergency obstetric care (EmOC) services in public-sector secondary and tertiary health facilities in Osun State, Southwest, Nigeria. Using a two-stage probability sampling procedure, 7 health facilities based in 6 randomly selected Local government areas (LGAs) were involved in the study. Data were obtained through the use of primary and secondary sources. For primary sources, a questionnaire was administered to 112 health workers and the study also utilized a checklist for equipment inventory. For secondary sources we reviewed existing hospital records on technology acquisition and maintenance. Relevant descriptive and inferential statistics were used for the data analysis. Almost three-fifths (58.1%) of the health workers considered the technical facilities for the delivery of EmOC in their facilities as inadequate, the proportion of health workers with such opinion was significantly higher in secondary compare to tertiary facilities (60.0% vs 40.0%, p=0.003). The inventory review and use of the checklist also showed varying degree of inadequate technical facilities; none of the facilities had all the 26 equipment considered as essential for comprehensive EmOC in functional state. We concluded that the public sector facilities in Osun State have inadequate technical facilities for EmOC; addressing this technological challenge will be critical to improving maternal health outcomes and statistics in Nigeria

Reproductive Health Aspirations and Unmet Needs in Urban Slums in Ibadan and Kaduna, Nigeria: A Qualitative Exploration

Reproductive health issues of urban slum dwellers are among the most challenging in Africa. Studies have generally examined this issue across the rural-urban dichotomy, without specific focus on urban slum dwellers. Many of these studies are also mostly quantitative. We utilize the qualitative approach to fathom the aspirations and challenges of urban dwellers in the domain of reproductive health. The results confirm that they aspire for smaller-sized families and healthy sexual and reproductive lives but are constrained by religious and socio-cultural factors. Idioms associated with their aspiration and experiences were well documented. There is the need to intervene in order to improve the sexual health of urban dwellers

Reconstruction of Mandibular Defects Using Nonvascularized Autogenous Bone Graft in Nigerians

Objectives: The aim of this study is to evaluate the success rate and complications of mandibular reconstruction with nonvascularized bone graft in Ile‑Ife, Nigeria. Patients and Methods: A total of 25 patients who underwent reconstruction of mandibular discontinuity defects between January 2003 and February 2012, at the Obafemi Awolowo University Teaching Hospitals Complex, Ile‑Ife constituted the study sample. Relevant information was retrieved from the patients’ records. This information include patients’ demographics (age and sex) as well as the type of mandibular defect, cause of the defect, type of mandibular resection done, source of the bone graft used, and the method of graft immobilization. Morbidity associated with the graft procedures were assessed by retrieving information on graft failures, length of hospital stay following surgery, rehabilitation device used and associated graft donor and recipient site complications. Result: There were 12 males and 13 females with a male:female ratio was 1:1.1. The age of the patients ranged from 13 to 73 years with a mean age for males 32.7 ± standard deviation (SD) 12.9 and for females 35.0 ± SD 17.1. Jaw defect was caused by resection for tumours and other jaw pathologies in 92% of cases. Complete symphyseal involvement defect was the most common defect recorded 11 (44%). Reconstruction with nonvascularized rib graft accounted for 68% of cases while iliac crest graft was used in 32% of the patients. Successful take of the grafts was recorded in 22 patients while three cases failed. Wound dehiscence (two patients) and postoperative wound infection (eight patients) were the most common complications recorded. Conclusion: The use of nonvascularized graft is still relevant in the reconstruction of large mandibular defects caused by surgical ablation of benign conditions in Nigerians. Precise surgical planning and execution, extended antibiotic therapy, and meticulous postoperative care contributed to the good outcome.Keywords: Mandibular defect, mandibular reconstruction, nonvascularized bone graf

Double burden of malnutrition among school-aged children and adolescents: evidence from a community-based cross-sectional survey in two Nigerian States

Background: Double burden of malnutrition (DBM) is the co-existence of overweight/obesity and undernutrition. Rising prevalence rates of childhood overweight/obesity in Nigeria have been reported, whilst undernutrition continues to be prevalent. This study aimed to estimate the prevalence and distribution of underweight, stunting, thinness, overweight/obesity, and DBM among school-aged children and adolescents in two Nigerian States. Methods: This was a community-based cross-sectional study carried out in Osun and Gombe States. A total of 1,200 children aged 6 - 19 years were recruited using multi-stage sampling technique. Weight, height and data on demographic, socio-economic, household/family characteristics of the children were collected using structured interviewer administered questionnaires. Nutritional status was calculated using the WHO 2007 reference values using BMI-for-age (thinness, overweight/obesity), height-for-age (stunting) and weight-for-age (underweight). DBM was described at the population and individual levels. Results: The mean age of the respondents was 11.6 ± 3.8 years. The overall prevalence rate of stunting was 34.9%, underweight was 13.5%, thinness was 10.3% and overweight/obese was 11.4% and 4.0% had individual level DBM, which typifies the DBM at individual and population levels. These rates differed significantly across demographic, socio-economic and household/family characteristics (p < 0.05). Gombe State, which is in the Northern part of Nigeria, had significantly higher burden of stunted, underweight and thin children than Osun State, while Osun State, in the Southern part of Nigeria, had a significantly higher burden of overweight/obesity. Conclusions: The study found evidence of DBM both at population and individual levels. The overall prevalence rates of stunting, underweight, thinness and overweight/obesity in this study were high, and they differed significantly across the demographic, socio-economic and household/family characteristics. There is the need for government and all other stakeholders to design nutritional educational programmes that will target both under- and over-nutrition among older children in the different contexts

'Children eat all things here': a qualitative study of mothers' perceptions and cultural beliefs about underweight and overweight children and adolescents in selected communities in two Nigerian states

INTRODUCTION: The perception of mothers about causes of underweight and overweight among children or adolescents and associated cultural beliefs may influence nutritional status. However, data from qualitative studies on this subject and regarding age 6-19 are scarce in Nigeria. OBJECTIVE: This study aimed to explore mothers' perceptions and cultural beliefs about underweight and overweight children and adolescents in selected communities in a northern and a southern Nigerian state. DESIGN: This was a qualitative study using focus group discussions (FGD). Eight FGD sessions were held. The interviews were transcribed verbatim, and the transcripts were coded and analysed using NVivo V.11, and direct quotations representing the themes generated from the perspectives were cited as appropriate. SETTING: The study was carried out in eight randomly selected rural and urban communities in Gombe and Osun states of Nigeria. PARTICIPANTS: Seventy-six mothers of children and adolescents aged 6-19 years. RESULTS: The mothers identified concepts, causes and community experience of underweight and overweight children and adolescents, however, some gaps and misconceptions were observed. These included perspectives that suggest a limited understanding of the concepts of mild and moderate malnutrition and stunting and citing of 'witches and wizards' as causes of malnutrition. The mothers observed that being underweight was more prevalent in rural communities of Osun and Gombe states, while overweight was more prevalent in urban communities in Osun state. The majority of the women reported no known food taboo or restrictions, and no cultural beliefs relating to the nutrition of children and adolescents. CONCLUSION: Gaps and misconceptions exist in the perceptions of mothers on underweight and overweight children and adolescents. Food taboos, food restrictions and other cultural beliefs were not reported by majority of the mothers. Educational programmes for mothers on child/adolescent nutrition should target identified gaps and misconceptions