Prediction of low birth weight from other anthropometric parameters in Nnewi, south eastern Nigeria

Background: Low birth weight is a global problem but presents a major burden on the neonatal services in developing countries such as Nigeria, and brings to bear a greater strain on the meagre resources available for health care delivery and family financing. In a resourceconstrained setting as ours, proper weighing of all newborn infants and medical surveillance of low birth weight infants, although highly desirable, are often not achieved due to unavailability of suitable, functional weighing scales. There are serial cut-off points for the various anthropometric indices for the normal birth weight babies below which any baby is termed low birth weight. This study assessed the predictive values of anthropometric measurements in the detection of low birth weight newborn babies and also determined the local specific cut-off points for these measurements in Nnewi, Southeast Nigeria.Methods: This was a crosssectional study in which length, occipitofrontal circumference, mid-arm circumference and maximum thigh circumference of 428 singleton babies were ascertained within 24 hours of delivery. Data were analysed using the Statistical Package for Social Sciences (SPSS) software. Correlation and linear regression analyses were done to examine the linear relationship between the predictors and birth weight. The sensitivity, specificity and predictive values were calculated at serial cut–off points and the points of best discrimination determined.Results: The low birth weight prevalence was 15.2%. Maximum thigh circumference attained the highest correlation with birth weight (r = 0.904), greatest coefficient of determination (r2=0.817), and least measure of dispersion around the actual birth weight. Thus maximum thigh circumference, which has a cut-off point of 16.75cm, was the best predictor of low birth weight, with 98.5% sensitivity, 92.3% specificity and diagnostic accuracy of 93.2% (P<0.001).Conclusion: Routine measurements of maximum thigh circumference in resource-poor countries is an effective proxy for weight at birth in prenatal assessments and epidemiologic surveys.Key words: anthropometric parameters,low birth weight, newborn, Nigeri

Caregivers’ satisfaction and supervision of primary health care services in Nnewi, Nigeria

Although major gains were made in the reduction of childhood health indicators in the previous decade, stagnations or reversals were seen in many countries since the 1990s. Despite presence of primary health centers (PHC) in Nigeria, there are still high levels of morbidity and mortality among children because the quality of child health services falls short of what it could be in the country. Supportive supervision of PHCs should also improve the quality of child health services. This study assessed the level of clients’ satisfaction with care received and the quality of supervision of child health services in selected PHC facilities of Nnewi, Nigeria. The study design was cross sectional. Four health facilities were selected by simple random sampling technique from a list of 12 public PHC facilities that provide at least three of the range of essential child health services. Using interviewer administered questionnaire, data were collected from 305 caregivers and analyzed accordingly. Also key informant interviews were used to elicit information facility supervision frequency and adequacy. The mean age of the mainly female caregivers was 31.9 ± 9.4 years. Majority of the caregivers attended health facilities closest to them but 18.5% of the 65 who do not, said they did not like the health workers. Although more than 80% of clients were satisfied with quality of child health services received, yet 41.3% of them felt that the number of service days were inadequate. None of the health facilities had a work plan, supervision schedule or supervision checklist. Increasing the number of service days and providing supervision schedules and checklists at the health facilities can improve caregiver satisfaction and hopefully enhance quality of child health services at the PHCs.Key words: Caregivers, satisfaction, supervision, PHC, Nnew

Effectiveness of data collection and information transmission process for disease notification in Anambra State, Nigeria

Background: Disease surveillance and notification (DSN) has been shown to be weak in Nigeria, thus, its inability to promptly detect and control epidemics.Objective: To examine the completeness and timeliness of data collection and information transmission process for DSN in the Anambra state.Materials and Methods: The study was of cross‑sectional design and employed the multistage sampling method to select 270 health workers who are involved in DSN in Anambra state. Data were collected by a mix method of interviewer administered questionnaire and observational checklist preceded by key informant interviews and desk review.Results: One hundred (43.9%) health workers reported regular supply of Integrated Disease Surveillance and Response (IDSR) forms, 25% and 16.2% reported it was irregular and usually out of stock, respectively. Most facilities (81.5%) returned completed forms monthly. Secondary health facilities were less likely to submit completed forms, while majority of primary health facilities submitted theirs monthly (X2 = 4.42, P = 0.035). With respect to correctness of records, Health Management Information System records (55.6%) were the least correct, while out‑patient register (88.9%) was the most correct. Only 10.0% of health facilities submitted completed forms 5 days after completion, 88.9% of them submitted completed IDSR002 forms within 2 days of completion, while the remainder was submitted 4 days later.Conclusion: The health workers were not operating the DSN system in the State to optimal functionality. Recommendations were therefore made for the periodic training–retraining of health personnel on DSN, improved funding, provision of logistics, improved supervision, and feedback of information.Keywords: Data collection, disease notification, effectiveness, information transmission processNigerian Journal of Clinical Practice • Oct-Dec 2013 • Vol 16 • Issue

Comparative Analysis of Patient Satisfaction Levels in HIV/AIDS Care in Secondary and Tertiary Health Care Facilities in Nigeria

Background: Continuous quality improvement is linked to the use of timely and useful feedback from clients in HIV care. HIV experts and care professionals agree that consumer involvement, such as patient satisfaction survey, is an essential part of HIV care and policy making today. The introduction of Antiretroviral Drugs (ARTs) services in Nigeria has significantly impacted positively on the overall well being of people living with HIV/AIDS (PLWHAs). However, there is little understanding of their satisfaction and perception of quality of care provided. Objective: This study comparatively assessed patients' satisfaction with ambulatory HIV/AIDS care in secondary and tertiary health facilities in Anambra State. Methods: This was a descriptive comparative crosssectional study of 300 PLWHAs conducted at Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi (150) and at St. Charles Borromeo Catholic Hospital (SCBH), Onitsha (150). Sample selection was by systematic sampling technique whereby every 3rd patient registered to see the doctor each day was recruited. Data was collected using a structured interviewer-administered questionnaire and analyzed using SPSS version 13. Results: Patients in Nnewi were more likely to spend more 2 money on transport (÷ = 33.36, p=0.0001), while those in Onitsha were more likely to incur more expenses on non-HIV 2 tests (÷ = 5.73, p=0.017). Patients visiting the tertiary health facility were significantly more satisfied with access to care than those visiting the secondary health care facility were, (

Complete Hydatidiform Mole Coexisting with a Live Fetus

Hydatidiform mole co-existing with a normal fetus is very rare. We report a case of a 36 year old woman Para 4+0 who presented with amenorrhoea of twenty four weeks duration, vaginal bleeding , abdominal pain and  pre-eclampsia. Ultrasound examination revealed a hydatidiform mole  coexisting with a normal living fetus. The patient underwent a caesarean section at twenty eight weeks for maternal distress due to unbearable   abdominal pain. The baby died after seven days. Post operatively she had an eclamptic fit and developed oliguria and persistent trophoblastic disease which were all successfully treated.Key words: hydatidiform mole, living fetus, perisitent trophoblastic disease

Predictors of Road Traffic Accident, Road Traffic Injury and Death among Commercial Motorcyclists in an Urban Area in Nigeria

No Abstract

Birth preparedness and emergency readiness of pregnant women in Amaku general hospital Awka, Nigeria

Background: Birth preparedness and emergency readiness constitute a comprehensive strategy to improve the use of skilled providers at birth and a key intervention to decrease maternal mortality. Complications can arise at any time during pregnancy, childbirth, and post-partum period. These emergencies can be life-threatening requiring urgent intervention to mitigate their effects. This study assessed the birth preparedness and emergency readiness of antenatal clinic attendees in Amaku General Hospital Awka, Nigeria.Method: The study design was cross sectional and it employed systematic sampling technique to recruit consenting 100 antenatalclinic attendees from whom socio demographic and knowledge data were obtained using interviewer administered questionnaire. Thedata were analyzed with the statistical package of social sciences (SPSS).Result: Their mean age was 27.9+4.5 years. Half of the respondents registered for ANC before 20 weeks gestational age while 93%identified a health facility for delivery. As many as 78(78%) of the respondents had started buying materials and supply needed fordelivery, and 65(65%) were already saving money for the same purpose. Although 70(70%) of the subjects had arranged foremergency transportation, only 6(6%) had made arrangement for a blood donor.Conclusion: Despite efforts to provide fully equipped health facilities for basic and emergency obstetrics care, pregnant women needre-orientation to anticipate and plan for untoward events.Key words: Plan, birth, emergency readiness, pregnant women, Awka

Effect of health education on mothers' knowledge of management of malaria in Dunukofia L.G.A., Anambra State, Nigeria

Objective: About 20% of malaria episodes in Nigeria are treated in the health centres, while care provided at home and community ranked first in the actions taken during illness in under fives. These treatments are usually incorrect or sub-optimal, because of inadequate knowledge of malaria and its management. The main purpose of this study is to test the effectiveness of health education in enhancing the knowledge of home management of malaria by mothers in Dunukofia Local Government Area of Anambra State. Methods: Two rural communities, Ifitedunu and Ukwulu, in Dunukofia LGA were randomized into study and control communities. A total of 425 mothers with children aged 0-5 years were studied. Data were collected at baseline and 3 months post-intervention using a structured, pre-tested interviewer administered questionnaire. The data collected were analyzed by means of SPSS version 11 software to compute mean score, chi-square test and percentages. The hypotheses were tested at 0.05 percent level of significance. Results: The knowledge of correct mode of transmission of malaria increased significantly after intervention from 80.3% to 89.6%. Majority of the women recognized fever and loss of appetite as symptoms of malaria in children pre and post intervention (79.3%-94.8%). Following the intervention, identification of headache, chills and rigor, body aches and pains as features of malaria in underfives improved from 21.6-42.7% to 70.6-84.4%. Conclusion: There is a strong need for sustained health education of mothers in the communities to improve their general knowledge about malaria and their home management of the disease.Key Words: Health Education, Mothers, Malaria Management, Anambra

Comparative analysis of prevalence of intimate partner violence against women in military and civilian communities in Abuja, Nigeria

Carol Uzoamaka Chimah,1 Prosper Obunikem Uche Adogu,2 Kofoworola Odeyemi,3 Amobi Linus Ilika4 1Medical Department, Ministry of Defence Headquarters, Abuja, Nigeria; 2Department of Community Medicine and PHC, Nnamdi Azikiwe University/Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria; 3Department of Community Health, University of Lagos, Lagos, Nigeria Introduction: Intimate partner violence (IPV) occurs across the world, in various cultures, and affects people across societies irrespective of economic status or gender. Most data on IPV before World Health Organization multicountry study (WHOMCS) usually came from sources other than the military. Result of this study will contribute to the existing body of knowledge and may serve as a baseline for future studies in military populations. This study compares the prevalence of the different types of IPV against women in military and civilian communities in Abuja, Nigeria.Methods: Using a multistage sampling technique, 260 women who had intimate male partners were selected from military and civilian communities of Abuja. Collected data on personal characteristics and different types of IPV experienced were analyzed to demonstrate comparison of the association between the different forms of IPV and the respondents’ sociodemographic and partner characteristics in the two study populations using percentages and Χ-square statistics, and P-value was assumed to be significant at ≤0.05.Results: The prevalence of the four major types of IPV was higher among the military respondents than among civilians: controlling behavior, 37.1% versus 29.1%; emotional/psychological abuse, 42.4% versus 13.4%; physical abuse, 19.7% versus 5.9%, and sexual abuse, 9.2% versus 8.8%. Significantly more respondents from the military population (59 [45.4%]) compared to civilians (21 [19.4%]) were prevented by their partners from seeing their friends (P=0.000). The situation is reversed with regard to permission to seek health care for self, with civilians reporting a significantly higher prevalence (35 [32.4%]) than did military respondents (20 [15.4%]) (P=0.002). The military respondents were clearly at a higher risk of experiencing all the variants of emotional violence than the civilians (P=0.00). The commonest form of physical violence against women was “being slapped or having something thrown at them, that could hurt”, which was markedly higher in the military (43 [33.1%]) than in the civilian population (10 [9.3%]), (P<0.05).Conclusion: IPV is a significant public health problem in Abuja, and the military population is clearly at a higher risk of experiencing all forms of IPV compared to the civilian population. The military should encourage and finance research on effect of military operations and posttraumatic stress disorders on family relationships with a view of developing evidence-based treatment models for military personnel. Keywords: intimate partner violence, prevalence, military, civilian, women, Abuja, Nigeri