Knowledge, attitude and practice of Nigerian specialist doctors in training of cervical cancer and its screening

Introduction: Cancer of the cervix is the second commonest cancer among women worldwide, the commonest female genital‑tract malignancy in Nigeria, and one of the leading causes of morbidity and mortality among women in Nigeria. Health workers are the trusted source of medical information and their attitude and practice toward diseases of public health importance like cervical cancer are very critical if the country must make progress toward the prevention of such diseases. This work assesses the knowledge, attitude, and practice of Nigeria’s specialist doctors in training toward cervical cancer and its methods of screening because this is critical to its prevention in the country.Materials and Methods: This is a cross‑sectional study involving the administration of pretested structured questionnaire to fifty specialist Nigerian doctors in training in various disciplines from different parts of the country.Results: The knowledge of the participants regarding cervical cancer and its screening is very good, with an average of 98%, but their attitude toward cervical cancer screening is poor as only 7 (14%) had ever recommended a woman for cervical cancer screening. The practice of cervical cancer screening among the participants is poor as only 5 (22.7%) of the 22 female doctors in training had ever screened for cervical cancer and only one male specialist doctor in training out of the 28 of them had the partner screened for cervical cancer before this study. Only 4 (9%) of the 28 males had ever recommended cervical cancer screening to their female partner and 44 (88%) of the specialist doctors in training had never spoken to any organization about cervical cancer screening.Conclusion: Though the knowledge of Nigerian specialist doctors in training on cancer of the cervix and its screening is very good, their attitude to it and practice are very poor.Keywords: Attitude; cervical cancer screening; knowledge; Nigerian specialist doctors; practic

Correlation between serum uric acid levels and outcomes of pre-eclampsia in Abakaliki, South-east, Nigeria

Background: Pre-eclampsia is a leading cause of fetomaternal and perinatal morbidity and mortality. The role of serum uric acid (SUA) in determining the complications of preeclampsia has been controversial. This study compared mean SUA levels between severe pre-eclamptics and normotensive women at term and ascertained its correlation with outcomes of preeclampsia; as well as determined if there is a threshold value of SUA level beyond which fetomaternal complications occur.Methods: A case-controlled study where 80 severe pre-eclamptics at term and 80 normotensive women matched for gestational age were recruited. Blood samples were collected from them for assay of SUA levels and they were followed till delivery. The fetomaternal outcomes and the corresponding SUA levels at diagnosis were documented and variables statistically analyzed. A receiver operating characteristic curve was used to determine the cut-off value of SUA beyond which adverse fetomateral complications are likely to occur in pre-eclampsia.Results: The mean SUA level in severe pre-eclamptics (0.283±0.09 mmol/l) was not significantly higher than that of normotensive women (0.263±0.09 mmol/l, p=0.13). There was a weak positive correlation between the SUA levels and fetomaternal outcomes [maternal (r=0.102, p=0.236) and fetal (r=0.096, p=0.226)]. The study was unable to identify the threshold SUA level at which adverse fetomaternal outcomes occur as the values of SUA were closely related.Conclusions: SUA levels of pre-eclamptics and normotensive women did not show significant difference and correlated weakly with fetomaternal outcomes and are therefore poor predictor of fetomaternal outcomes in pre-eclampsia

Experiences and challenges of gynecological endoscopy in a low-resource setting, Southeast Nigeria

Background: The scope of endoscopy is expanding more and more as experience is gained with training and collaborations, however, these expansions could be slowed by challenges. Objectives: To determine the experiences and challenges of gyne-endoscopic surgery. Materials and Methods: This study was a prospective analysis of all women undergoing gynecologic endoscopy at Federal Teaching Hospital Abakaliki (FETHA), Nigeria from 2012 to 2014. Patients were recruited based on eligibility for endoscopy surgery. Written informed consent was obtained before any of the gyne-endoscopic surgery. Ethical approval for the study was given by the ethics and research committee of FETHA. Laparoscopy and hysteroscopy were performed by the managing team. EPI Info version 3.5.1 statistical software (Atlanta, GA, USA) was used for data analysis. Results: Seventy-three different gyne-endoscopic surgeries were done, with dye test accounting for majority 28 (77.8%). The duration of surgery ranged from 23 to 248 minutes, and the surgery with the longest duration was total laparoscopic hysterectomy while laparoscopy and dye test had the shortest operating time. The mean duration of hospitalization was 20.3 ± 14.4 hours. There were 2 (5.6%) conversions to open surgery. Most common complication was abdominal pain 26 (72.2%). The challenges include third party partnership, lack of vital equipment, poor maintenance, epileptic power supply, late presentation of cases, and misconception. Conclusion: Gyne-endoscopy is essential in contemporary medicine. Reduction in operating time occurs as skills and experience improve; the challenges are many

Knowledge, attitude and practice of Nigerian specialist doctors in training of cervical cancer and its screening

Introduction: Cancer of the cervix is the second commonest cancer among women worldwide, the commonest female genital-tract malignancy in Nigeria, and one of the leading causes of morbidity and mortality among women in Nigeria. Health workers are the trusted source of medical information and their attitude and practice toward diseases of public health importance like cervical cancer are very critical if the country must make progress toward the prevention of such diseases. This work assesses the knowledge, attitude, and practice of Nigeria's specialist doctors in training toward cervical cancer and its methods of screening because this is critical to its prevention in the country. Materials and Methods: This is a cross-sectional study involving the administration of pretested structured questionnaire to fifty specialist Nigerian doctors in training in various disciplines from different parts of the country. Results: The knowledge of the participants regarding cervical cancer and its screening is very good, with an average of 98%, but their attitude toward cervical cancer screening is poor as only 7 (14%) had ever recommended a woman for cervical cancer screening. The practice of cervical cancer screening among the participants is poor as only 5 (22.7%) of the 22 female doctors in training had ever screened for cervical cancer and only one male specialist doctor in training out of the 28 of them had the partner screened for cervical cancer before this study. Only 4 (9%) of the 28 males had ever recommended cervical cancer screening to their female partner and 44 (88%) of the specialist doctors in training had never spoken to any organization about cervical cancer screening. Conclusion: Though the knowledge of Nigerian specialist doctors in training on cancer of the cervix and its screening is very good, their attitude to it and practice are very poor

Utilisation of preconception care services and determinants of poor uptake among a cohort of women in Abakaliki Southeast Nigeria

Preconception care (PCC) is a preventive strategy for maternal and perinatal morbidity and mortality. This study aimed to assess the level of awareness and utilisation of PCC services. A descriptive cross-sectional survey was conducted at a teaching hospital. Interviewer-administered questionnaires were used to extract information. A total of 450 participants responded; 44.2% (190/450) were aware, 31.7% (143/450) had good knowledge, while only 10.3% (46/450) received PCC. Health care providers were the main source of information (77.9%). There was statistically significant correlation between awareness and participants’ level of education (p < .001) and residence (p < .001), as well as between utilisation and education (p < .001), and information from doctors (p < .001). There was a low level of awareness and poor utilisation of PCC, underpinning the need to scale up health education, establishment of functional PCC clinics and formulation of evidence-based guidelines to improve uptake and pregnancy outcome.Impact statement What is already known on the subject of the paper? PCC has been known in high-income countries as a prevention-based strategy, which aims at improving obstetric outcomes. However, the level of utilisation in low-income countries like Nigeria is either unknown or far too low. What do this study add? This work has provided local data on PCC; clearly indicating that the awareness and utilisation of PCC services in Abakaliki, Nigeria is very low when compared with other regions of the world, and this was influenced by the socio-demographic factors – particularly education and place of residence (for awareness), and level of education and information from health care providers (for utilisation), thus suggesting that enlightenment and improvement in social infrastructures could improve awareness, access and utilisation of PCC. What are the implications for clinical practice and/or further research? The implications of these findings in low resource settings like ours will include introducing interventions to scaling up health education, universal establishment of functional PCC units and formulation of evidence-based guidelines aimed at improving the uptake of PCC and pregnancy outcome. Further research will also be needed in future to assess the impact of such interventions and how to sustain potential benefits

Choice of birth place among antenatal clinic attendees in rural mission hospitals in Ebonyi State, South-East Nigeria.

BACKGROUND:Low utilization of health facilities for delivery by pregnant women poses a public health challenge in Nigeria. AIM:To determine the factors that influence the choice of birth place among antenatal clinic attendees. METHODOLOGY:This was a cross-sectional study of the eligible antenatal clinic attendees recruited at Mater Misericordiae Hospital, Afikpo and Saint Vincent Hospital, Ndubia in Ebonyi State from February 1, 2016 to June 30, 2016. Analysis was done using EPI Info 7.21 software (CDC Atlanta Georgia). RESULTS:A total of 397(99.3%) completely filled questionnaires were collated and analysed. Approximately 71% of the health facilities closest to the respondents had maternity services. It took at least 1 hour for 80.9% of the respondents to access health facilities with maternity services. Most (60.2%) of the respondents had at least one antenatal clinic attendance and majority of them did so at public hospitals. Approximately 43.8% of the respondents were delivered by the skilled birth attendants. The respondents' age and the couple's educational level, history of antenatal clinic attendance, distance of the health facility and availability of transport fare had a significant effect on delivery by skilled birth attendants. The common determinants of birth place were nearness of the health facilities, familiarity of healthcare providers, improved services, sudden labour onset and cost. Also 61.7% of the respondents chose to deliver in public health facilities due to favourable reasons but this could be hampered by the rudeness of some healthcare providers at such facilities. A significant proportion of private health facilities had unskilled manpower and shortage of drugs. CONCLUSION:A greater proportion of women will prefer to deliver in health facilities. However there are barriers to utilization of these facilities hence the need to address such barriers