Referral System: An Assessment of Primary Health Care Centres in Plateau State, North Central Nigeria

Background: An effective referral system ensures a close relationship between all levels of the health system and helps to ensure patients receive the best possible care close to home. There appears to be a weak link of referral system in chain of continuity of care across the levels of health care in Nigeria placing huge demands on secondary and tertiary levels of care for health care service provision. In view of this, this study was conducted to assess the level of practice of referral and factors influencing it among health workers in PHCs in Plateau state North central Nigeria. Methodology: This was a cross sectional study conducted among 228 frontline health care workers in PHCs. SPSSS version 20 was used for data analysis, adjusted odds ratio as well as 95% confidence interval were used in this study with a p-value of le 0.05 considered statistically significant. Results: The respondentsrsquo mean age was 38.0 plusmn 9 years with slight above half 116 (54.2%) having good understanding of the concept of referral and mostnbsp 77.6% had referred at least a case within the last one month. nbspFactors such as good understanding of the concept of referral (AOR = 6.2 95% Cl = 1.4556 ndash 8.7991) and availability of referral system (AOR = 8.4 95% Cl = 2.1168 ndash 15.5450) were predictors of the practice of referral. Conclusion: This study has demonstrated the level of practice of referral among cadres of health care workers at PHCs level with significant need for improvement

Prevalence and spectrum of cervical cytological abnormalities among brothel based sex workers in Jos, Nigeria

Background: Cervical cancer is the second most common cause of cancer-related death among women in sub-Saharan Africa. Female sex workers being high-risk group are more susceptible to infections with the Human Papillomavirus and thus, the development of the premalignant and malignant disease of the cervix. We therefore sought to determine the prevalence and spectrum of cervical cytological abnormalities among female sex workers in Jos, Nigeria. Methods: A cross-sectional study was conducted among Brothel based sex workers (BBSW) aged 18years and above in Jos, Nigeria between March 2018-February 2019. Papanicolaou test technique was the screening method used to detect premalignant lesions. Data were entered and analyzed using STATA version 15.1 software. Results: A total of 201 participants were recruited for the study. One hundred and ninety-four (194) had adequate smears and were included in the analysis. Of this 80.4% were negative for intraepithelial malignancy, while 19.6% were positive for intraepithelial malignancy and this included ASCUS (10.3%), LSIL (4.6%), HSIL (3.6%), AGUS (0.5%) and ASC-H (0.5%). Abnormal cervical cytology was seen more in participants that were single, between the ages of 24-34years, multiparous, with a previous history of sexually transmitted disease, and have greater than 2 clients/day, but all these were not statistically significant. Conclusion: Due to the high prevalence of abnormal cervical cytology among BBSW, there is a need for them to have regular screening, follow-up, and treatment of premalignant lesions to prevent progression to frank cervical cancer

Risky sexual behaviour and associated factors among female students of a Tertiary institution in North-Central Nigeria

Background: Human sexual behaviour is the way in which humans experience and express their sexuality. It could be risky and non-risky. Risky  sexual behaviours including early sexual debut, unprotected sexual intercourse, multiple sexual partners and having sex under the influence of  alcohol or drugs. Objective: This study assessed the sexual practices and factors associated with risky-sexual behaviour of the female students. Methodology: This was a cross-sectional study involving 400 female students of the Plateau State Polytechnic. The subjects were selected from all  the departments using a two-stage sampling technique. A pretested semi-structured selfadministered questionnaire was used to obtain relevant  information from the subject. Analysis was done using IBMSPSS 22.0. Statistical significance was set at p < 0.05. Results: Sixty-four percent of the respondents had sexual debut at age 19-23 years. Fifty-two percent had sex with only one partner within the last  six months while respondent's sexual partners were mostly male. About 92% practiced vaginal sex, 6.2% oral sex and 2.3% anal sex. Less than one-quarter and 19.2% of the study participants used condom always and did negotiate for safer sex respectively. There was a significant association  between substance use and risky-sexual behaviour. Conclusion: There is a high prevalence of risky-sexual behaviours among the study cohort.  These were seen from the high percentage of the female students who had sexual debut before the age of 18 years, unprotected sexual intercourse  as well as multiple sexual partners. Substance use, desire for pleasure, expression of love, and quest for money were the factors  associated with sexual behaviour of the cohort