An audit of the uptake of key PMTCT interventions in the pre and post who rapid advice periods at the university college hospital, Ibadan

Prevention of vertical transmission of HIV may require the uptake of the culturally unacceptable options of cesarean delivery and formula feeding. The successful use of HAART, as enumerated by the WHO 2009 rapid advice, has the potential for facilitating the uptake of the more culturally acceptable vaginal delivery and breast feeding. These recommendations became operational at the PMTCT unit, University College Hospital, Ibadan. This retrospective study describes the impact of these recommendations on the uptake of PMTCT interventions at our center. The pre-rapid advice period was June 2009 to April 2011 and the post rapid period May 2011 till December 2012. Pre-rapid advise, antiretrovirals administered was zidovudine or Combivir for women with CD4 >200cells / ml and Combivir/nevirapine for CD4 <200 Cells/ ml. Post-rapid, all were eligible for HAART (mostly efavirenz/ truvada or efavirenz/ Combivir). Six weeks post-natally, the options adopted were documented and are presented here. Information from 1165 women was available. Thirty three (2.8%) did not have adequate information and were excluded. There were 711 women pre-rapid advise and 421 women post rapid. The women's characteristics were not significantly different over both periods, 69.0% had >6 years of education, 97.0% were married and slightly over half (56.9%) were involved with traders. Overall, more women were delivered by the vaginal route than Caesarean Delivery (70.5% vs. 29.5%), while more breastfed compared to formula feeding (67.2% vs. 32.8%). In the post rapid period (compared to the pre- rapid) advise, more women had vaginal delivery (73.5% vs. 64.8%, p = 0.54), more women breast-fed (77.0% vs. 50.1%, p= 0.00) and fewer women used contraception (21.5% vs. 27.3%, p= 0.023). The commonest method was the condom (83.4%). The new WHO guidelines appear to have facilitated a shift in uptake of the more culturally acceptable options of vaginal delivery and breast feeding. A follow-up evaluation of the infant HIV status will ascertain the ultimate impact on MTCT

Ameliorative Effects of Adansonia Digitata Leaf Extract on Carbon Tetrachloride (CCL4) Induced Testicular Toxicity in Adult Male Wistar Rats

Adansonia digitata is locally consumed as food in Nigeria. In the present study, the ameliorative effect of the aqueous leaf extract of Adansonia digitata (AeAD) was evaluated in carbon tetrachloride (CCl4) – induced testicular toxicity in Wistar rats. To evaluate the effect of AeAD in CCl4 induced testicular toxicity, 20 adult male Wistar rats were equally divided into 4 groups (n=5). Group A animals received 1 ml olive oil per os (p.o) for two weeks, Group B animals received 2.5 ml/kg CCl4 (50% in olive oil, p.o) for two days, Group C animals received 500 ml/kg AeAD (p.o) for two weeks while Group D animals received 2.5 ml/kg CCl4 (50% in olive oil, p.o) for two days followed by 500 ml/kg AeAD (p.o) for two weeks. The ameliorative effects of AeAD were observed on reproductive hormonal parameters, activity of an antioxidant enzyme and cyto-architecture of the testis. Carbon tetrachloride treatment significantly (P<0.05) reduced levels of testosterone, follicle stimulating hormone, luteinizing hormone and superoxide dismutase levels with distortions in the cyto-architecture of the testes in treated animals. These effects were ameliorated with AeAD treatment. The results demonstrated that the AeAD has the ability to ameliorate against carbontetrachloride-induced testicular toxicity  suggesting it may have a therapeutic role in free radical mediated diseases.Keywords: Antioxidant; SOD; Testes; Histology

Test-retest reliability of IPAQ environmental- module in an African population

<p>Abstract</p> <p>Background</p> <p>There is overwhelming evidence of the benefits of physical activity and the physical environment is increasingly recognized as a promising determinant of physical activity participation. The influence of the environment on physical activity has not been evaluated among black Africans and no specific measure exists for assessing environmental factors related to physical activity in an African environment. The IPAQ E- module was designed to assess environmental factors for physical activity participation and was considered to be relevant to all countries regardless of the stage of economic development. The objective of this study was to assess the test- retest reliability of IPAQ E- module in an African population.</p> <p>Methods</p> <p>One hundred and three clinical students of a University in Nigeria were invited to participate in the reliability testing of IPAQ E- module. Sixteen of the 17- items on the environmental measure were assessed for test- retest reliability using intraclass correlation coefficient (ICC) with 95% Confidence interval (CI) overall and by gender. The measure addressed items regarding residential density, access to destinations, neighborhood infrastructures, aesthetic qualities, social environment, street connectivity and neighborhood safety.</p> <p>Results</p> <p>Of the total respondents, 51.5% were males and 48.5% were females. Overall, the intraclass correlation coefficient (ICC) ranged from 0.43 to 0.91. The item regarding many interesting things to look at (aesthetic) produced the overall highest reliability score (ICC = 0.91, 95% CI = 0.86 – 0.94), while the item regarding safety from crime during the day (neighborhood safety) produced the lowest overall score (ICC = 0.43, 95% CI = 0.26 – 0.57). Reliability of items on neighborhood infrastructures ranged between substantial agreement to almost perfect agreement overall (ICC = 0.66 – 0.88) and by gender (male- ICC = 0.68 – 0.90 and female- ICC = 0.63 – 0.86). The access to destination items (ICC = 0.49 – 0.74), social environment (ICC = 0.62) and street connectivity (ICC = 0.78) all had acceptable reliability overall. Meaningful differences were found between males and females on two items on neighborhood safety and one item on access to destinations.</p> <p>Conclusion</p> <p>The test- retest of IPAQ E- module resulted in moderate to almost perfect agreement for most of the items with few meaningful differences by gender. Environmental items of physical activity in an African population exhibited reliability similar to that in other environments. These results suggest that IPAQ E- module may be a useful measure for assessing environmental correlates of physical activity among population in Africa.</p

Cigarette Smoking Practices and Its Determinants Among University Students in Southwest, Nigeria

Background: Tobacco smoking is one of the largest causes of preventable morbidity and mortality globally, and is responsible for many causes of premature deaths. This study seeks to find out cigarette-smoking practices among University Students in Ekiti State, Nigeria and identify its determinants. Methodology: This study was a descriptive cross-sectional study of young adults in tertiary institutions. The sample size was 300 while multi stage sampling technique was adopted to select the students that were interviewed. The pre-tested questionnaire was semi structured and it was self administered. Data analysis was done using Epi-Info version 3.4.1. Frequency tables and cross-tabulations were generated with a statistical significance p-value pre-determined at less than 0.05. Results: The prevalence of students that ever smoked was 66 (22.0%) while those that currently smoke are 41 (13.7%). Of the students that smoked, largest proportion (53.0%) smoked for pleasure. The mean age at onset of smoking was 15.14 + 4.34 while the mean number of sticks smoked per day was 4.46 + 4.59. Introduction to smoking was mainly by friends at home (48.6%), colleagues in school (33.3%) and siblings (18.1%) The factors that were positively associated with smoking habits were male sex, alcohol consumption, having a friend/relative that smokes, having no prior education on the dangers of smoking. They were all statistically significant. Conclusion: Peer influence is a very important source of cigarette smoking among the youths. Previous education on dangers of smoking and the perception that smoking is risky to health significantly reduced the prevalence of smoking. It is therefore recommended that health education on the risks associated with smoking be introduced to young adults early

Prevalence and risk factors of cervical cancer among women in an urban community of Kwara State, North Central Nigeria

Background. Cervical cancer is the second most common malig- nancy in women worldwide with a high incidence in under-devel- oped countries and Nigeria is one of these countries. This study aimed at screening for cervical cancer using Papanicolaou smear and to identify risk factors for cervical cancer among women in Olufadi community, Kwara state, North-central Nigeria. Methods. This was a cross-sectional study involving the screening of women aged 25-64 years for cervical cancer using Papanicolaou smear. Respondents were selected through systematic random sam- pling of households. Interviewer- administered questionnaire and clinical report form were also used to collect data. In addition, Pap smear samples were taken. Data was analyzed using SPSS version 15. Results. Only 10 (5.0%) respondents had positive cytology result, while the rest were normal. Of the 10 positive cytology results, 1(10.0%) was high grade squamous intraepithelial lesion (HGSIL) while the remaining 9(90.0%) were low grade squamous intraepithelial lesion (LGSIL) which corresponds to 0.5% and 4.5% of the total respondents respectively. Risk fac- tors for cervical cancer identified included coitarche, tobacco smoking, number of sexual partners and family history of cervi- cal cancer. Conclusion. The findings from this study attest to the increasing burden of cervical cancer. The high number of positive results obtained from the study coupled with the presence of risk factors was an indication of how useful regular screening will be in the early detection of cervical cancer

Work-related musculoskeletal disorders among Nigerian Physiotherapists

<p>Abstract</p> <p>Background</p> <p>Physiotherapists are known to be prone to Work- related musculoskeletal disorders (WRMDs) but its prevalence among physiotherapists in Nigeria has not been reported. This study investigated the prevalence and work factors of WRMDs among physiotherapists in Nigeria.</p> <p>Methods</p> <p>A cross- sectional survey was administered to physiotherapists in different parts of Nigeria using a 2- part questionnaire with items adopted from questionnaires used for similar studies around the world. Two hundred and seventeen copies of the questionnaire were distributed for self administration but 126 physiotherapists returned completed surveys for a 58.1% response. The data were analyzed using SPPS version 10 at alpha level of 0.05. Descriptive statistics of frequency and percentages and inferential statistics of <it>x</it>²were used as appropriate for data analysis.</p> <p>Results</p> <p>Reported 12- month prevalence of WRMDs among Nigerian physiotherapists was 91.3%. Prevalence of WRMDs was significantly higher in female physiotherapists (p = 0.007) and those with lower body mass index (p = 0.045). The low back (69.8%) was the most commonly affected body part, followed by the neck (34.1%). Fifty percent of the physiotherapists first experienced their WRMDs within five years of graduation and the highest prevalence (61.7%) was found among physiotherapists younger than 30 years. Treating large number of patients in a day was cited by most (83.5%) of the respondents as the most important work factor for their WRMDs. The most commonly adopted coping strategy identified was for the therapists to modify their position and/or the patient's position (64.3%). Majority of the respondents (87.0%) did not leave the profession but 62.6% changed and/or modified their treatment because of their WRMDs.</p> <p>Conclusion</p> <p>The prevalence of WRMDs among physiotherapists in Nigeria is higher than most values reported for their counterparts around the world. The coping strategies and work factors of WRMDs among Nigerian physiotherapists are mostly similar to those of their counterparts elsewhere.</p