Prevalence of Human Immunodeficiency Virus Infection and Risky Sexual Behaviours among Clients Attending HIV Testing Service in Ogun State, Nigeria

Background: HIV testing services (HTS) are a component of HIV prevention and care programs in developed countries and have proven to be a cost-effective way of monitoring the disease, reducing risky behaviours and leading patients to other services. Objective: To determine the prevalence and risky behavioural factors associated with HIV among the attendees of HIV testing services in a part of Ogun state, Nigeria. Methods: This was a descriptive cross-sectional study of HTS clients in health facilities within Ogun State, Nigeria. A multi-stage sampling technique was used for data collection using a pretested, close-ended, interviewer-administered questionnaire. Results: A total of 800 respondents with a mean age of 32.57±10.39 years were surveyed. The prevalence of HIV was 1.6%. The majority (93.6%) of the respondents were sexually experienced. The percentage tested previously among study participants was 5.0%. This significantly comprised those below the age of 18 years (X2 = 22.01, p = 0.0001) and female respondents (Χ2 = 4.84, p = 0.028). Only 21 (2.6%) have had unprotected sex with a casual partner. Significantly more of the female respondent had been involved in this risky sexual behaviour (X2 = 4.52, p = 0.034). Only 7 (0.9%) had sex with multiple sexual partners in the last three months, and 17 (2.1%) were positive for symptomatic STI screening. Conclusion: The prevalence of HIV was low to be 1.6%, and the percentage tested previously was 5.0%. The practice of free HIV screening should be maintained to encourage more people to undergo the test

Retrospective analysis of mathieu’s urethroplasty for anterior hypospadias repair in circumcised children: A single center experience

Introduction: Mathieu’s technique (peri-meatal based flap) makes use of the urethral plate in the repair of anterior hypospadias, thereby creating an almost natural neo-urethra. In a circumcised baby or after previous unsuccessful repair, Mathieu’s flap may be one of the few options left torepair anterior hypospadias.Objectives: To evaluate the result of Mathieu’s flap repair for anterior hypospadias in a resource poor setting.Materials and Method: This is a retrospective review of post-circumcision anterior hypospadias managed by Mathieu’s flap repair between January 1996 and December 2006 in the paediatric surgical unit of the Obafemi Awolowo University Teaching Hospital, a tertiary hospital in theSouth Western Nigeria.Results: Mathieu’s flap repair was performed in 16 patients with isolated anterior hypospadias; 15 (93.8%) were circumcised before presentation. The complications were urethrocutaneous fistula in 3 (18.8%), wound infection in 2 (12.5%) and flap necrosis in 1 patient (6.3%). Final outcomewas satisfactory in all patients.Conclusion: Mathieu’s flap remains a viable option in the repair of anterior hypospadias even after circumcision

Metastatic choriocarcinoma presenting as advanced renal cell carcinoma: A case report

Choriocarcinoma is an aggressive tumour arising as a malignant transformation of the gestational trophoblastic disease or rarely from the germ cells in the ovary and from testicular mixed germ cell tumour. Renal involvement due to Choriocarcinoma is rare we report here one of such rare cases. A 26yr old woman presented with painful right sided loin swelling with painless total haematuria of 3weeks duration .Abdominal Ultrasound and CT scan showed a solid Right kidney mass with a cystic component. She had right radical nephrectomy.Histopathological examination revealed metastatic choriocarcinoma. The challenges we faced in her management is highlightedand a brief review of literature on the subject is presented

Challenges of Surgical Repair of Hypospadias in Ile-Ife, Nigeria

Objective: To document the presentation, outcome and challenges of management of hypospadias in a resource-limited setting.Patients and Methods: For this retrospective study we analyzed the files of  all patients with hypospadias managed at the Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria between 1996 and 2006. The parameters studied were the patients’ bio-data, clinical presentation,treatment and outcome. Results: During the 10-year period under review 51 cases of hypospadias were managed. The majority of the patients (n=39, 76.5%) presented within the first year of life with a mean age atpresentation of 1 year and 8 months, though most of the repairs were done in the 2nd, 3rd and 4th years of life. Of the 51 patients 46 (90.2%) came from rural and semi-urban areas and 18 (35.3%) had been circumcised before presentation. Surgical repair consisted of preputial island flap in 22 patients (43.1%) followed by a peri-meatal based flap (Mathieu procedure) in 16 patients (31.4%). The MAGPI procedure was used in 5 patients (9.8%) and the Snodgrass procedure in 1 (2%).Staged repair was necessary in 7 patients (13.7%). Post-operative complications were encountered in 15 patients with urethrocutaneous fistula being the commonest one (11 patients, 21.6%). Conclusion: Our results show that hypospadias can be successfully managed in a low- resource setting

Knowledge and experience of medical students with male urethral catheterization

Background: Urethral catheterization is a commonly performed procedure. Therefore medical students should receive adequate training in this technique to avoid devastating consequences of performing it poorly. This study was aimed at finding out the knowledge and experience of final year medical students with the technique of male urethral catheterization.Methods: Well-structured questionnaire was administered to each of the final year medical students of Ladoke Akintola University of Technology (LAUTECH) one week to their final examinations.Results: All the 215 students received the questionnaire one week before their final examinations with 128 (60%) completing it. The male to female ratio was 1:1 with a mean age of 28 years. One hundred and twenty-five (98.4%) of the students had been throught male urethral catheterization. Thirty-five (27.6%) of the students have never performed male urethral catheterization. One hundred and fifteen students (90.6%) agreed that urethral catheterization is a sterile procedure. Sixty-nine (54.3%) students said xylocaine jelly should be used as lubricant.. Ninety four (74%) students said that they will inflate the balloon of the catheter when the Y junction gets to the tip of the penis. Forty-nine (38.6%) students said they are very confident about male urethral catheterization, 61 (48.0%) said reasonably confident while 5 (3.9%) are not confident at all.Conclusions: Urethral catheterization is a common procedure. Students should receive adequate instruction in this technique to avoid devastating consequences of performing it poorly

Characteristics of clients accessing HIV counseling and testing services in a tertiary hospital in Sagamu, Southwestern Nigeria

Introduction: Client-initiated HIV testing and counseling has helped millions of people learn their HIV status. Nevertheless, global coverage of HIV testing and counseling programs remains low. This study describes the characteristics of clients who accessed HIV counseling and testing (HCT) services in Olabisi Onabanjo University Teaching Hospital, (OOUTH)Sagamu.Materials and Methods: A retrospective study of the clients accessing HCT services in OOUTH. Data was collected from clients using a client intake form. Pre-test counseling, HIV screening and post-test counseling were carried out. Informed consent and confidentiality were ensured. Data obtained were analyzed using SPSS 10.0.Results: A total of 2607 clients accessed our HCT services between May 1st 2008 and April 30th 2010. The clients were between the ages of 1 year and 90 years. The mean age was 33.3 ± 15.26. The median age was found to be 32.0 years, with the modal age being 30.0 years. 73.7% (1828) were non-reactive (negative result), 25.9% (643) were reactive (positive result), while 0.3% (8) were indeterminate. Among the reactive results, 9.3% (242) were males while 15.1% (394) were females.Conclusion: A fair uptake of HCT services was noted. More females accessed services than males. More positive results were seen among females than males (P<0.05).Recommendations: Upscale of HCT services to involve Sexually transmitted infections clinics and free-standing, client-initiated testing centers is necessary. Continuous AIDS education and risk reduction should be promoted

Retrograde ejaculation related infertility in Ile-Ife, Nigeria

Background: Globally, the incidence of male infertility is on the increase1,2. However, the contribution of retrograde ejaculation to this increasing incidence of male infertility is not known locally.Objectives:1. To determine the incidence of retrograde ejaculation by using the WHO criterion among male partners of patients who were being managed for infertility at the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria between 1st of February and 31st of August 2006 . 2. To determine the Retrograde-ejaculation ratio (RER) of each subject by a proposed formula as an extension of the WHO criterion.3. To highlight the risk factors and the management options available for the treatment of retrograde ejaculation.Subjects and methods: During the study period, 71 male partners of consecutive female patients who reported at the Infertility clinic were recruited. However, the specimens of 70 male partners were analyzedbecause one of them inadvertently spilled his post-ejaculatory urine specimen and consequently was excluded from the study. Prior to the collection of ejaculatory fluid and post-ejaculatory urine specimens foranalysis, they were instructed to abstain from sexual intercourse for at least 3 days and to collect the first post-ejaculatory urine specimen for analysis. The WHO criterion 1 states that a cloudy urine specimen with the presence of a total number of spermatozoa in urine equal to or exceeding the number of spermatozoa in semen, strongly supports the diagnosis of retrograde ejaculation. The sperm counts in seminal fluid and urine for each subject were determined. Thereafter, the sperm concentration in urine (SCU) and sperm concentration in seminal fluid(SCSF) were determinedrespectively thus: sperm count in urine/volume of urine; sperm count in seminal fluid/ volume of seminal fluid. The Retrograde ejaculation ratio (RER) was calculated thus: sperm count in urine / sperm count inseminal fluid. A questionnaire containing the bio-data and risk factors associated with retrograde ejaculation was completed for each subject.Results: Of the 70 cases included in the analysis, 32(45.7%) had primary infertility while 38(54.3%) had secondary infertility. The age range was 28-65(mean for primary and secondary infertility were 36 and 42.1respectively) years. The duration of infertility ranged from 1-16 years (mean4+ 2.92). Based on the WHO criterion previously stated, only 1/70(1.42%) of the cases was positive with a retrograde ejaculatory ratio(RER) of infinity as he had azoospermia. This was in a 47 year old man with secondary infertility who had no identifiable risk factor prior to the study. There were 8/70(11.42%) of the cases studied with azoospermia but only 1/8 (12.5%) of those azoospermic had retrograde ejaculation.Conclusion: To make a diagnosis of male factor infertility, semen analysis remains the cornerstone of all the laboratory assays. However, to make acategorical diagnosis of retrograde ejaculation, focused laboratory testing is imperative. The incidence of retrograde ejaculation appeared low (1.42%) in our environment but this is in consonance with studies elsewhere. It is strongly advisable that cases of azoospermia and severe oligozoospermia be screened for retrograde ejaculation as there are manymodalities of therapy to aid the affected males fulfil their wishes of becoming fathers. Lastly, when the retrograde ejaculation ratio (RER) is > 1 with the presence of a cloudy urine, the diagnosis is highly probable.Key words: Retrograde ejaculation, azoospermia, male infertility

In vitro resistance of gram-negative enteric bacilli from wound infections to honey

Letter to the Edito

Impact of mobile technologies on cervical cancer screening practices in Lagos, Nigeria (mHealth-Cervix): Protocol for a randomised controlled trial

Background: Incidence and mortality from cervical cancer have remained high due to many obstacles facing the implementation of organized screening programs in resource-constrained countries such as Nigeria. The application of mobile technologies (mHealth) to health services delivery has the potential to reduce inequalities, empower patients to control their health, and improve the cost-effectiveness of health care delivery. Aim: To assess the efficacy of mobile technology intervention on Pap test screening adherence compared to a control condition and also determine the factors affecting the uptake of Pap smear screening practices among women in Lagos. Methods: This is a multi-center randomized controlled trial that will involve women aged 25 to 65 years attending the General Outpatient clinics of the two tertiary health institutions in Lagos, Nigeria between April and December 2020. At baseline, a total of 200 National Health Insurance Scheme (NHIS) enrollees will be randomized to either a text message arm or usual care (control) arm. The primary outcome is the completion of a Pap smear within 6 months of enrolment in the study. The associations between any two groups of continuous variables will be tested using the independent sample t-test (normal distribution) or the Mann-Whitney U test (skewed data) and that of two groups of categorical variables with Chi-square X2or Fisher's exact test where appropriate. Using binary logistic regression model, we will adjust for age and other relevant sociodemographic and clinical variables and adherence to Pap test screening. Statistical significance will be defined as P-value less than 0.05. Discussion: The mHealth-Cervix study will evaluate the impact of mobile technologies on cervical cancer screening practices in Lagos, Nigeria as a way of contributing to the reduction in the wide disparities in cervical cancer incidence through early detection facilitated using health promotion to improve Pap smear screening adherence. Registration: PACTR202002753354517 13/02/202