Knowledge, Attitude and Willingness to Screen Younger Infants for Sickle Cell Disease among Mothers attending Immunization Clinic in an Urban Community in Lagos, Nigeria

Background: Over 300,000 babies are born worldwide with sickle cell disease, mostly in low- and middle-income countries with the majority of these births in Africa. Nigeria has the largest population of people with sickle cell disease with about 150,000 children born with the disease every year. This study assessed the knowledge, attitude and willingness to screen younger infants for sickle cell disease among mothers attending immunization clinic in an urban community in Lagos, Nigeria.Methods: A cross-sectional descriptive study was carried out at primary health care centres in Somolu Local Government Area in Lagos, Nigeria. Two hundred and ninety-one mother-infant pairs were consecutively recruited from August 2019 to January 2020. Data were collected with a pre-tested, interviewer-administered questionnaire. The analysis was done using SPSS version 22 software. Univariate and bivariate analysis were conducted with the level of significance set at p<0.05.Results: The mean age of respondents was 29.9 ± 5.4 years. Most 212 (72.9%) were aware of sickle cell disease. One hundred and fifty-one (71.2%) of those who were aware of sickle cell disease had good knowledge while 148 (69.8%) had a positive attitude towards SCD prevention. Majority of the respondents 180 (84.9%) were willing to screen their infants for sickle cell disease. A statistically significant association was found between good knowledge and positive attitude towards SCD (p<0.001).Conclusion: There is the need for increased education of mothers of younger infants attending routine immunization clinic about SCD for better knowledge, attitude and willingness for early infants screening of SCD

Community perception of quality of health care received and client satisfaction in Lagos, Nigeria

Background: Quality of health care and client satisfaction are key elements in improving the performance of health systems. A community-based assessment was conducted to determine the level of client satisfaction and the perception of the quality of services received by citizens of Lagos State.Methods: A descriptive cross-sectional study using both quantitative and qualitative methods, was conducted in four local government areas of Lagos State. Respondents were selected by multi-stage sampling technique. The survey instruments included an interviewer-administered, pre-tested questionnaire and a 10-itemed focus group discussion guide.Results: Two thousand respondents with a mean age of 37.6±10.21 years were recruited. Almost all respondents (98%) rated the health facilities to be clean, 96% felt they received effective treatment from their providers. Six out of ten respondents rated the waiting time to be short and 60% felt that most drugs were available. Eight-five percent opined that the quality of care received was good and 95% were satisfied with the services received. There was a significant correlation between quality of care and client satisfaction (ρ=0.145, p=0.001). Short waiting time was predictive of client satisfaction (OR=13.9, 95%CI, 5.68-33.33, p<0.001) and confidence in health care providers was predictive of both client satisfaction (OR=3.489, 95%CI, 1.554-7.835, p<0.001) and perception of good service quality (OR=2.234, 95%CI, 1.509-3.308, p<0.001).Conclusion: Adequate attention needs to be paid to factors affecting client satisfaction and perception of good service quality.Keywords: Quality; Client satisfaction; Health services; Health systems; Lago

Testicular function following oral exposure to Tramadol and Cannabis sativa ethanol extracts in male Wistar rats

Objective: Substance abuse is a global challenge. This study investigated the effects of two commonly abused substances, tramadol and/or  Cannabis sativa ethanol extracts (ECS), on testicular function in Wistar male rats.Methods: Twenty-animals were equally divided into 4groups that received 0.9%NaCl (0.2ml), tramadol (40mg/kg), ECS (2mg/kg) and tramadol + ECS for 30days, respectively (daily p.o). Following anesthesia, blood samples were obtained and serum testosterone was determined. Testes and  epididymis were harvested and weighed. Sperm motility, viability and counts were evaluated in the epididymis while superoxide dismutase (SOD), catalase, lactate dehydrogenase (LDH) levels and histology (Haematoxylin & Eosin) were evaluated in the testis.Results: Sperm motility, viability, counts, testosterone level and testicular CAT was reduced in all experimental groups compared to control. Relative epididymal weights increased in tramadol only and ECS only compared to control. Testicular SOD was decreased only in the tramadol only and co-treatment (tramadol + ECS), respectively. LDH was increased in the tramadol only treatment group. Testicular histology in tramadol and co-treatment groups showed structural aberrations that are consistent with impaired spermatogenesis, antioxidant depletion and oxidative stress.Conclusion: Abuse of tramadol and/or Cannabis sativa ethanol extracts may predispose to testicular dysfunction resulting from decline in testicular antioxidants, testicular steroidogenesis and spermatogenesis. Keywords: Tramadol, Cannabis sativa, spermatogenic function, oxidative stress, testicular architectur

Cervical Cancer Awareness and Screening Uptake among Rural Women in Lagos, Nigeria

Background: Cervical cancer is the most common cause of female genital cancer and female cancer deaths in developing countries such as Nigeria. The most recent government estimates put the number of new cases at 25,000 per year. According to the latest global estimates, 493, 000 new cases occur each year and 274,000 women die of the disease annually. This study therefore determined the awareness, knowledge and use of cervical cancer screening services among rural women in Lagos State, Nigeria.Method: A cross sectional, descriptive study design was adopted and a total of 400 women were studied. Data was collected using a structured, interviewer-administered questionnaire. The questionnaire elicited information about socio-demographic characteristics, awareness, knowledge and use of screening services. Univariate and bivariate analyses were done with Statistical Package for Social Sciences (SPSS) version 16. Significance level at 5%Results: Age range of study participants was 25-65years and a mean age of 38.9± 9.51 years. Most of the respondents (85.0%)were not aware of cervical cancer. However, amongst those who were aware of cervical cancer, 66.7% got the information from the media. Only a few (13.3%) of the respondents have ever been screened and none of the screening was in the last 3 years. Majority (86.7%) of the respondents expressed willingness to undergo cervical cancer screening.Conclusion: There was low awareness of cervical cancer and screening uptake among the respondents and the overall knowledge was equally poor. However, the respondents showed a strong willingness for screening. There is need for community education and awareness among the rural women at large as this would engender a more positive attitude and increased use of screening services

Route of exposure influences the cardiovascular effects of Cannabis sativa in salt-induced hypertensive male Wistar rats

Background: Exposre to Cannabis sativa (CS) has been suggested to exert ameliorative effects in hypertensive conditions. Using various exposure routes, this study investigated the likely cardiovascular protective effect of CS in high salt diet (HSD) induced hypertensive male Wistar rats. Methods: Exposure routes investigated include dietary incorporation (10%CS+90%HSD), ethanol extract of C. sativa intake (ECS, 3mg/kg p.o.), and inhalation of C. sativa fumes (1g/day/animal). GC-MS analysis of CS was evaluated, and forty animals were equally divided into 5 groups as follows; Group I (control) received normal diet, Groups II-V received HSD alone, CS+HSD, ECS+HSD, and CS fumes+HSD for 28days, respectively. Thereafter, systolic, diastolic, mean arterial blood pressure, and electrocardiographic readings were assessed. Haematological analysis of retro-orbital sinus blood samples after light anaesthesia was also evaluated for full blood cell counts, erythrocyte sedimentation rate, fibrinogen concentration, and blood viscosity. Aortic samples were harvested for histology. Resulte: The GC-MS showed Δ9-Tetrahydrocannabinol, Δ9-Tetrahydrocannabivarin, Cannabidiol and Cannabinol, as prevalent in CS. The HSD only exhibited elevated (P<0.05) RBC, PCV, haemoglobin, MCV, platelets, WBC, neutrophil, blood viscosity, systolic, diastolic and mean arterial blood pressure compared to control. CS exposure groups (III-V) exhibited reduced (P<0.05) RBC, PCV, haemoglobin, WBC, blood viscosity, systolic, diastolic and mean arterial blood pressure compared to HSD only. However these values were elevated compared to control. ECG tracings seen in group II suggests myocardial electrical signal dysfunction while tracings in the CS exposure groups suggest partial amelioration of myocardial signalling pathways. Histology showed hypertension-induced aortic structural alterations that were not ameliorated by exposure to CS. Conclusion: Data obtained suggest that controlled exposure to Cannabis sativa either in diet, as ethanol extract or inhalation may mediate elevated blood pressure and impaired cardio-electrical signalling in salt (NaCl)-induced hypertension. However, hypertension-induced cardiac structural and vascular impairments are not ameliorated by exposure to Cannabis sativa Keywords: Hypertension, Cannabis sativa, blood pressure, aort

Utilization of health facilities and preferred places of treatment for common health conditions in Lagos, Nigeria

Background: When people are ill, the options for health-seeking behavior are shaped by several factors. Understanding these options is likely to contribute to early treatment and better outcomes. The objective of this study was to investigate the utilization and preferred places for treating common health problems in Lagos, Nigeria. Methods: A cross-sectional survey was conducted using both an interviewer administered questionnaire and focus group discussions to obtain data. Participants were recruited through multi-stage sampling methods from four local government areas in Lagos State. Conditions of interest included fever in children, cough, diarrhoea and vomiting and pregnancy care. The Statistical Package for Social Sciences (SPSS) version 22 software was used for analysis while the qualitative data was analyzed with ATLAS.ti software version 7. The level of significance was set at p< 0.05. Results: Two thousand participants were recruited. The mean age was 37.6±10.21years. Government hospitals were the most frequent usual source of health care (41%). Perceived effectiveness of treatment, speed of service and low cost were main reasons for these choices. Other sources of care such as drug store, nursing homes and trado-medical facilities were preferred more frequently by more than a third of respondents for most conditions except for pregnancy care. Primary Health Care centers were the least preferred sources of care. Conclusion: Primary Health Care centres were the least utilized sources of care. Increased advocacy is a recommended strategy to improve early presentation to health facilities

Knowledge and Attitude of Public Secondary School students towards Sickle Cell Disease in Lagos, Nigeria

Introduction: Sickle cell disease (SCD)is the most prevalent genetic disorder in Africa. Nigeria has the largest population of people with sickle cell disease, with about 150,000 births annually.Objectives: This study assessed awareness, knowledge and attitude of students in public secondary schools in Lagos state about SCD.Materials and Methods: A cross-sectional descriptive study was conducted among 350 senior secondary students selected through multistage sampling technique. Data were collected using aself-administered structured questionnaire and analyzed with SPSS version 20 with level of significance set at p≤0.05.Knowledge score of respondents was graded as poor, fair and good based on the total percentage score while the attitude score was graded as poor and good based on the average score.Results: The mean age of respondents was 15±1.3 years. More than half of the respondents 227 (64.9%) had ever heard of SCD and the most common source of information was from mass media 80(35.2%).About ten percent of the respondents 34(9.7%) had good  knowledge of SCD. The mean knowledge score of the respondents was 12.80±2.73 out of 22.More than two-third 266(76.0%) of the respondents did not know the difference between genotype and blood group while more than half 200 (57.1%) referred to genotypeas being same as blood group and a higher proportion of the respondents233(66.4%) did not know their haemoglobin genotype. Less than half 150(42.9%) knew that premarital genotype testing was a method of prevention of sickle cell disease. About half (52.3%) of the respondents had good attitude.Conclusion: Good knowledge of SCD was found to be very low and good attitude towards SCD was average among the respondents. Ahigher proportion of the respondents did not know their haemoglobin genotype. Hence, more education and awareness to improve the knowledge and attitude of secondary school students towards SCD is recommended. Key Words: Knowledge, Attitude, Sickle-cell Disease, Secondary School Students