Human Papilloma Virus Vaccine: Determinants of Acceptability by Mothers for Adolescents in Nigeria

Vaccination of adolescent females against Human Papilloma Virus (HPV), the causative agent for cervical cancer has recently become available. As minors, parental acceptance of the vaccines for adolescent daughters requires exploration. This was a cross-sectional survey of 201 mothers attending the gynaecology clinic in a University Teaching Hospital in Nigeria on acceptability of the HPV vaccines and its determinants. Although 70% accepted vaccination of their daughters, 30% were unwilling and the commonest reason for unwillingness was that it may encourage sexual promiscuity (62.3%). Mothers with poor knowledge of STI were significantly more unwilling to accept HPV vaccines compared to those with average or good knowledge (p=0.002). Furthermore, perception of susceptibility to HPV infection by daughters was significantly associated with acceptance of the vaccines (p=0.0001). Increased advocacy and public enlightenment on cervical cancer control and the role of HPV vaccines in its prevention is still necessary especially in developing countries. (Afr J Reprod Health 2014; 18[3]: 154-158)Keywords: Cervical cancer, Human papilloma virus, vaccine, Nigeri

Maternal Obesity in Early Pregnancy and Subsequent Pregnancy Outcome in a Nigerian Population

Despite a rising prevalence worldwide, there is limited data on pregnancy outcome among African women with prepregnancy or early pregnancy obesity. This was a case-control study to determine the prevalence of maternal obesity in early pregnancy and compare the subsequent pregnancy outcome between 201 women with obesity and 201 non-obese controls in a University Teaching Hospital in Nigeria. The prevalence of obesity in early pregnancy was 9.63%. Obesity was significantly associated with advanced maternal age and parity ≥ 1. It was also a risk factor for pregnancy induced hypertension, admissions during pregnancy, caesarean delivery and associated with 5th minute apgar score ≤3 (0.044). Obesity in early pregnancy is a risk factor for adverse pregnancy outcome among pregnant Nigerian women. This information should be utilised by physicians to improve the outcome of pregnancy and promote safe motherhood

Towards Reducing Cancer Death: An Exploratory Study Of Physicians Knowledge On Cancer Basic Facts

Objective: To explore the knowledge of basic facts on common female cancers amongst Physicians in active practice. Materials and Methods: A descriptive study among 160 doctors working in a Nigerian Teaching Hospital. Results: Majority of the physicians surveyed (86.2%) were in full time academic practice with 13.8% in combined academic and private practice. The experience (years in practice) of the Physicians varied from 1-22 years, with a majority (57.9%) in category A (1-5 years ), while 40.3% were in category D (>15 years). A large proportion of the Physicians had poor knowledge on basic cancer facts with regards to the prevalence (47.2%), mortality rate (54.1%), available screening tests (65.4%), and association between HPV and cancers of the anogenital region (56.6%). The type of practice did not significantly influence Physicians knowledge on basic cancer facts (P values > 0.05) More Physicians in full academic practice had good knowledge about human papilloma virus compared to those in combined practice (23.3% vs. 5%; fulltime academics vs. combine practice). There was no significant difference in the knowledge of the Physicians on the prevalence, available screening tests and mortality rate of the cancers based on their experience (P values > 0.05) Conclusion: Physicians in active practice have poor knowledge of basic cancer facts irrespective of their number of years in practice. These portend serious setback for health education, policy formulation on prevention and reduction of Cancer related morbidity and mortality. Keywords: Cancer, Human papilloma Virus (HPV), Knowledge, counsellin

Intimate partner violence among women with HIV infection in rural Uganda: critical implications for policy and practice

<p>Abstract</p> <p>Background</p> <p>Intimate partner violence (IPV) is a major public health problem in Africa and worldwide. HIV infected women face increased IPV risk. We assessed the prevalence and factors associated with IPV among HIV infected women attending HIV care in Kabale hospital, Uganda.</p> <p>Methods</p> <p>This cross-sectional study was conducted among 317 HIV infected women attending Kabale regional hospital HIV treatment centre, from March to December 2010. Participants were interviewed using an interviewer-administered questionnaire. Data was collected on socio-demographic variables, social habits, and IPV (using the abuse assessment screen and the Severity of Violence against Women Scale to identify physical, sexual and psychological violence). Characteristics of the participants who reported IPV were compared with those who did not. Multivariate logistic-regression analysis was conducted to analyze factors that were independently associated with IPV.</p> <p>Results</p> <p>The mean age of 317 respondents was 29.7 years. Twenty two (6.9%) were adolescents and 233 (73.5%) were married or cohabiting. The mean age of the spouse was 33.0 years.</p> <p>One hundred and eleven (35.0%) were currently on antiretroviral therapy. Lifetime prevalence of IPV (physical or sexual) was 36.6%. In the preceding 12 months, IPV (any type) was reported by 93 respondents (29.3%). This was physical for 55 (17.6%), and sexual /psychological for 38 (12.1%). On multivariate multinomial logistic regression analysis, there was a significant but inverse association between education level and physical partner violence (adjusted relative risk (ARR) 0.50, confidence limits (95% CI) 0.31-0.82, p-value = 0.007). There was a significant but inverse association between education level of respondent and sexual/psychological violence (ARR 0.47 95%CI (0.25-0.87), p-value = 0.017) Likewise, there was a significant inverse association between the education level of the spouse and psychological/sexual violence (ARR 0.57, 95% CI 0.25-0.90, p-value = 0.018). Use of antiretroviral therapy was associated with increased prevalence of any type of violence (physical, sexual or psychological) with ARR 3.04 (95%CI 1.15-8.45, p-value = 0.032).</p> <p>Conclusion</p> <p>Almost one in three women living with HIV had suffered intimate partner violence in the preceding 12 months. Nearly one in five HIV patients reported physical violence, and about one in every seven HIV patients reported sexual/psychological violence. Likewise, women who were taking antiretroviral drugs for HIV treatment were more likely to report any type of intimate partner violence (physical, sexual or psychological). The implication of these findings is that women living with HIV especially those on antiretroviral drugs should be routinely screened for intimate partner violence.</p

Commentary- The need to implement population based cervical cancer screening in limited resource settings using aided visual inspection of the cervix

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EDITORIAL: Attaining MDG 5 in northern Nigeria: Need to focus on skilled birth attendance

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