Knowledge, attitude and practice of contraception by female junior secondary school students in an urban community of Oyo-state, South west, Nigeria

Background: Unintended pregnancies resulting in several maternal morbidities and mortalities are still a major public health challenge in most parts of the world. Female secondary school students are particularly vulnerable due to their engagement in unsafe sex and low uptake of family planning services. The study assessed respondents’ level of knowledge on, attitude to and practice of family planning.Methods: A cross-sectional study was conducted among 240 consenting female junior secondary school students in two public schools in Ogbomoso, South West Nigeria. Multi-stage sampling method was employed in recruiting the study participants and facilitated self-administered semi-structured questionnaire used for data collection. Descriptive statistics was done and Chi-square test used to compare categorical variables. The level of statistical significance was set at p <0.05.Results: The mean age of the respondents was 13.6±2.3 and 69.5% of them were early adolescents (10-13years of age). Almost all (92.3%) of the respondents were aware of family planning but only 58.1% and 55.3% of them had good knowledge on and positive attitudes towards family planning respectively. In all, 64.0% of the sexually active respondents had ever used family planning. Condom was the commonest family planning method ever used; reported by 65.0% of those who had ever used family planning. Fear of side effects was the main reason among non-users.Conclusions: Family planning uptake among sexually active female students is low in Southwest Nigeria. There is urgent need for aggressive awareness campaigns to improve the knowledge score and attitude of students to family planning in Nigeria

Patterns and predictors of exclusive breastfeeding among mothers in Ile Ife, Nigeria

Background: Exclusive Breast Feeding (EBF) is a cost effective intervention in saving under-five children’s lives in the resource poor settings. However, EBF rates have been shown to be low in these regions with variation in the duration of EBF.Objective: The aim of this study was to assess pattern and predictors of EBF among mothers attending well infant clinic at Obafemi Awolowo University Teaching Hospital Complex (OAUTHC) Ile Ife.Materials and Methods: It was a cross-sectional study carried out between October and December 2014. A total of 250 eligible mothers were selected by simple random sampling among women attending well infant clinic OAUTHC, Ile Ife.A semi-structured selfadministered questionnaire was used.Results: The prevalence of EBF in this study was 23%. The pattern of EBF seen was in the duration of EBF. About 60% gave breast milk alone to their children only in the first month of life. Only 23% was breastfed exclusively for four to five months, while 5% breastfed exclusively for at least six months. About 40% practiced mixed feeding right from the first day of life.The predictors of EBF identified include; ANC attendance, a birth interval greater than or equal to 2 years, husband's positive attitude, giving breast milk as the first feed in life, and vaginal delivery.Conclusion: The practice of EBF within 4 to 6 months of life is still very low. Strategies that target improving access to quality ANC, and emphasize husbands’ roles in encouraging EBF should be giving priority.Keywords: Pattern, predictors, exclusive breastfeedin

PREDITORS AND ACCEPTABILITY OF HUMAN PAPILLOMA VIRUS VACCINE UPTAKE AMONG SENIOR SECONDARY SCHOOL STUDENTS IN ILE-IFE

Introduction: Cervical cancer is the second most common cancer in women worldwide and in Nigeria. Human papilloma virus (HPV), has been implicated as the causative agent of cervical cancer. The fact that HPV vaccination can prevent the occurrence of this deadly cancer is well established. Though the vaccine has been licensed in Nigeria since 2008 with widespread availability, it is yet to be included in National immunization program in Nigeria. This study aimed to assess the predictors and acceptability of the HPV vaccine among senior secondary girls in Ile-Ife. Methods: This descriptive cross-sectional study recruited 400 students randomly selected from various secondary schools in Ife central-local government. The data was collected with the use of a pre-tested interviewer-administered questionnaire on knowledge, attitude, and acceptability of cervical cancer, HPV and HPV vaccine. Data were analyzed using descriptive and inferential statistics. Results: Most respondents (93.2%) had poor knowledge of cervical cancer, HPV and HPV vaccine. Attitude towards cervical cancer and HPV vaccine was good and the majority (74.5% ) had high acceptability for the HPV vaccine. Only 2.8% of the respondents have been vaccinated. Predictors of acceptability of HPV vaccine were younger age group ((AOR) 4.05 ,CI= 2.30-5.45), good knowledge ((AOR =2.50,CI=2.31-6.83) , mother’ higher level of education (AOR= 1.55, CI=2.62- 4.58 ), perceived fatality of cervical cancer ( AOR=4.13,CI=1.49 – 4.19) and perceived efficacy of the HPV vaccine( AOR=1.57, CI= 0.49 – 3.18). Conclusions: The knowledge of secondary school girls in the study area on cervical cancer, HPV and HPV vaccine is poor though the HPV vaccine acceptability is high. The high acceptability of the vaccine in this study is a reflection of the willingness of this vulnerable group to learn more about the subject matter. There is the need to create school health programs that will focus on health educating the students on this preventable cancer and the available vaccine. Including HPV vaccine into National immunization program in Nigeria may also improve awareness of cervical cancer and the vaccine uptake

Knowledge of and Attitude Towards Epilepsy Among Women in Ile-Ife, Nigeria

Background: Epilepsy is a non-contagious chronic disease with sufferers experiencing embarrassments amidst other challenges. Family caregivers are mainly women with some of them suffering from the disease. This study assessed the knowledge and attitude of women residents in an urban community towards epilepsy. Materials and methods: This descriptive cross-sectional study recruited 400 randomly selected women in Ile-Ife. The data was collected with the use of a pre-tested interviewer-administered questionnaire on knowledge of and attitude to epilepsy. Data was analysed using descriptive and inferential statistics. Results: Most respondents (99.3%) were aware of the disease with their main sources of information from their parents, friends, and neighbours. Only 15.3% of respondents had good knowledge of epilepsy, while 35% had positive attitude to epilepsy. Factors associated with good knowledge of epilepsy among respondents include having higher education (OR = 3.154, 95%CI = 1.574–6.323, p = 0.001) and higher income (OR = 3.055, 95%CI = 1.404–6.651, p = 0.005), while factors associated with positive attitude towards epilepsy include older age group (OR = 1.943, 95%CI = 1.281–2.945,p = 0.002) and higher income (OR = 2.932, 95%CI = 1.345–6.386, p = 0.007). Conclusions: Although the level of awareness is high, respondents’ knowledgeand attitude were inadequate. There is a need for a community education about epilepsy, targeting women who are major stakeholders with the aim of improving their knowledge and attitude towards the disease

THE BURDEN OF VESICO-VAGINAL FISTULA IN ILE-IFE, SOUTH WESTERN NIGERIA

Background: Vesicovaginal fistula is a major cause of severe morbidity and potential mortality, which can result in marital disruption, rejection, and eventual destitution. Methodology: A retrospective study of all cases of vesicovaginal fistula managed over a 30 year period between 1st January 1984 and 31st December 2013 at the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria. Relevant data were obtained from the case notes and analyzed for the demographics, clinical features, management and outcome using SPSS version 20. Result: There were 213 patients with vesicovaginal fistula over the period of the study with aprevalence of 3.9 per 1000 deliveries. The age range was 15-45 years with a mean age of 24.8 years. Most of them were primiparous, (52.1%) and of the low social class (84.5%). Obstetric fistula accounted for 93.9%. The majority of them (64.8%) did not have antenatal care during the antecedent pregnancy. Labor was attended by unskilled attendants in about 90% of them while 92% labored for at least 24hours. The juxta-cervical fistula was the most common anatomical type (47.0%). The overall success rate at repair was 76.4%. Stillbirth rate in the antecedent pregnancy was 67.5%. Other associated morbidities included chronic vulva excoriation, obstetric palsy, and secondary amenorrhea. Conclusion:Vesicovaginal fistula (VVF) is a major public health problem in developing countries with too many calamities as shown in this study. Improving the educational and economic status of women in Nigeria will go a long way in empowering them to access quality antenatal care. This will also enhance hospital delivery thereby preventing prolonged obstructed labor which is a strong etiological factor for VVF. Decentralization of treatment centers and training of specialists in fistula surgery is very important to improving treatment outcomes

ECTOPIC CHORIOCARCINOMA IN A PRETEEN IN OGBOMOSO, SOUTH-WEST NIGERIA. A CASE REPORT

Ectopic Choriocarcinoma is an extremely rare occurrence. The case of ectopic choriocarcinoma discussed here involved a 12 year old girl who presented with lower abdominal pain and dizziness following a short period of amenorrhea after attaining menarche. Aprovisional diagnosis of ruptured ectopic gestation was made based on the clinical evaluation and patient had emergency laparotomy. Histopathology report revealed a choriocarcinoma of the ovary. Patient defaulted on subsequent follow up care. This case is presented as an eye opener on the need to also focus on the reproductive health challenges, early sex education in preteen and rare occurrence of the disease amongst the Pre-teenage groups. It is also important to deal with the possibility of a non gestational choriocarcinoma of the ovary which has a worse prognosis