Abstract: OBJECTIVE: To evaluate the knowledge of, and perception of female undergraduates in the Niger Delta of Nigeria towards Emergency Contraception. METHODS: Anonymous self administered questionnaires were applied to randomly selected non-medical female undergraduates of the University of Port Harcourt in May 2005. RESULTS: Six hundred questionnaires were retrieved out of 610 distributed. The respondents were between 17-30 years. Those reported to have ever had sex were 85.3%; most of whom (98.4%) have previously used some forms of contraception. About 50.7% of 600 respondents were aware of emergency contraception; amongst which reports of friends/peers as the source of knowledge ranked highest (33.55%). About 88.2% of those that are aware of Emergency Contraception knew the correct timing. More than half (57.9%) did not know correct dosage of the available post-coital pill. While half (50.7%) of those having knowledge of postcoital pills agree to the efficacy; only a third (35.53%) agreed to have actually used it. CONCLUSION: The awareness and use of Emergency Contraception amongst female undergraduates in Niger Delta region of Nigeria is low. Prompt education of this group of students in Emergency Contraception should be encouraged with emphasis on available methods and correct timing of use.
Abstract: OBJECTIVE: The study aimed to establish the prevalence of diabetes mellitus and the pattern of diabetic hand and foot ulcers in hospitalized adult patients in a teaching hospital in Port Harcourt, Nigeria. RESEARCH DESIGN AND METHODS: All medical admission at the University of Port Harcourt Teaching Hospital between January 2000 and April 2001 were included in this cross-sectional study. Diabetes mellitus was diagnosed based on a fasting venous plasma glucose >or=7.0 mmol/l or a 2-h post-prandial venous plasma glucose level of >or=11.1 mmol/L using the glucose oxidase method. Data was processed for the 60 diabetic patients with limb ulcers excluding ulcers from major trauma. RESULTS: The prevalence of diabetes mellitus was 38.1% (95% CI=34.8-41.4) among medical in-patients; while hand and foot ulcer was 19.1% among diabetic patients. The left lower limb ranked highest in ulcer involvement (32/60); hand ulcers were found in 5 cases (8.3%). Twenty (33.3%) of the patients had a previous limb ulcer. In 31 patients (51.7%) the ulcers evolved spontaneously without an identifiable cause (p-value=0.00). By Wagner's Grading System, Grade III lesions ranked highest (21/64). CONCLUSIONS: A high prevalence of hand and foot ulcers was confirmed among patients with diabetics, which are common indications for hospitalization, and usually associated with long hospital stay with adverse outcomes including amputation and death. Diabetes education needs to be stepped-up, with emphasis on foot care and early presentation to hospital in the event of limb ulceration.
Abstract: BACKGROUND: Nigeria is highly burdened by malaria and HIV-infection, yet researchers know little about the impact of this co-infection on the haematological profile of HIV-infected adult Nigerians. This case control study is an attempt to investigate the effect that HIV/malaria co-infection has on some haematological parameters of HIV-infected Nigerians. METHODS: Complete blood count (CBC) of 30 plasmodium parasitized HIV-infected subjects and 70 non-parasitized controls were studied. RESULTS: Of the 30 parasitized subjects, 28 (93.3%) were positive for falciparum malaria and 2 (6.7%) for vivax malaria. The incidence of anaemia, thrombocytopenia, neutropenia and leucopenia were significantly higher in parasitized subjects compared to non-parasitized controls 66.7%, 60%, 36.7% and 63.3% versus 32.9%, 42.9%, 24.3% and 24.3% respectively. A statistically significant difference was observed between the haemoglobin, platelet count and the erythrocyte sedimentation rate (ESR) of parasitized and non- parasitized individuals (p < 0.05) respectively. A significant positive correlation was observed between the level of parasitaemia and anaemia (r = 0.37, p < 0.04) in parasitized subjects. The incidence of anaemia was two times higher in parasitized subjects compared to non-parasitized controls (66.7% versus 32.9%). Red cell morphology showed a normocytic and normochromic picture in 40% and 67.1% of parasitized and non- parasitized individuals respectively. Microcytic, hypochromic picture was observed in 60% and 23% respectively in parasitized and non- parasitized individuals. Striking eosinophilia was seen in 5 (16.7%) of parasitized and 3 (4.3%) of non-parasitized individuals. CONCLUSION: Incidence of cytopenia appear significantly higher in parasitized subjects compared to non-parasitized control and bring to bare the need for regular anti-malaria prophylaxis for HIV-infected patients particularly in Nigeria.
Abstract: BACKGROUND: Evaluating the quality and performance of Primary Health Care (PHC) systems depend on the information system's capacity to generate reliable and accurate information, within social, cultural, and economic context. This paper reports an assessment of a PHC health management information system from PHC Managers'perspectives, METHODS: An adapted 3-part Donabedian model informed our assessment of the structure, process and outcomes of the PHC health information system. Pre-tested, semi-structured questionnaires were administered to the PHC Coordinator, 6 Deputy Coordinators, and 18 officers responsible for the health facilities in Bama Local Government Area of Borno State. RESULTS: Majority of the respondents (n=11) believed that staffing at PHC level was inadequate. Only 5 (27.8%) of the managers had training specific to completing HMIS forms. All the facilities were reported to possess registers for the study year (1993), but their numbers dropped by half consecutively down the preceding years to 1990. None reported a health facility that had a copy of the requisite M&E manual guide to HIMIS. Nonetheless 14 reported that report submissions were timely; chief factors causing delays were lack of transport (35.5%), bad roads (16.1%), and scarcity of forms (9.7%). Twelve (12) of the managers judged that the data collected were always or sometimes accurate. Though only 5 crosschecked data to verify accuracy of the submissions. Eight (8) were of the opinion that computerisation was not necessary for rural PHC information system, and eleven (11) felt that the Bama PHC was not ready for computerisation. Twelve (12) of them felt that the quality of the PHC information system had improved since its devolution to the LGA, however, the main suggestions offered to improve the MIS in general were personnel training (32%), feedback from higher levels (20%), and availability of transportation (16%). CONCLUSION: The information system is only as good as the organisation it serves. Results of this study show majorgaps in the structure of the HMIS at the PHC level which is responsible for gathering data onward to the federal level that culminates in epidemiological and health information for the country. Emphasis for intervention for strengthening information systems should be on starting with generating information for local use, and building local capacity to utilise derived information for daily PHC planning, decision-making and management before the prospect of collecting data for upward submission to higher levels.
Abstract: BACKGROUND: This descriptive cross-sectional study was conducted among prospective couples referred from Faith-Based Organisations in Port Harcourt, Nigeria for pre-marital HIV screening. The study sought to establish the sero-prevalence of human immunodeficiency virus (HIV) in this peculiar study group. METHODS: A total of 84 healthy heterosexual couples who required pre-marital HIV screening were tested between January 2000 and December 2003 using a Double ELISA confirmatory test of Immunocomb and Genscreen HIV I&II Kits. RESULTS: Amongst the 168 individuals tested, 35 (20.8%) were found positive. Seroprevalence was significantly higher among females 23 (27.4%) compared to males 12 (14.3%). Infection rate was highest in the 25-29 years group (29.7%, n=22) and lowest in those of 35-39 years (6.1 %, n=2), though this difference was not statistically significant (p-value=0.058). Infection rate was significantly higher among females (p-value=0.036); among prospective couples from Orthodox churches (p-value=0.021); couples with prolonged courtship (>6 months) (p-value=0.0001); couples with history of premarital sex (p-value=0.0001); and couples with history of cohabitation (p-value=0.0001). CONCLUSION: Our findings prompt a wake-up call for faith-based organizations (FBOs) to urgently initiate or be more receptive of measures that emphasize behavioural and social changes amongst members. Government and non-governmental organizations should organise capacity building training for religious based organizations to enable them cope with the challenges of HIV/AIDS. The outcomes of this study further underscores the value of voluntary counselling and confidential HIV testing and especially pre- and post-test counselling as the basis of pre-marital HIV testing.
Abstract: BACKGROUND: Most traditional practices in Africa, sustained and fuelled by underdevelopment, ignorance, illiteracy, poverty and tenacious customs, have been on the decline except for female genital mutilation (FGM). AIM: To ascertain the prevalence and operators of female genital mutilation (FGM). METHOD: A cross sectional study was carried out in a semi-urban town in Rivers State of Nigeria between January and April 1988, utilizing structured questionnaires which were randomly distributed. The response of 600 respondents was analyzed. RESULTS: Prevalence of FGM amongst the study population was 53.2%. Medical doctors were the most mentioned operators (34.5%) followed by traditional birth attendants (33.8%). Control of excess female sexual desires (58.2%) and promotion of culture (39.5%) were the major reasons adduced for this practice. CONCLUSION: The enforcement of the World Health Organization (WHO) legislation against medicalization of this practice is advocated. Training and retraining of traditional birth attendants with emphases on eradication of harmful cultural practices will help.
Abstract: OBJECTIVES: This study aimed to assess the prevalence rates of type 2 diabetes and to determine potential associated risk factors of the disease in Port Harcourt, Nigeria. RESEARCH DESIGN AND METHODS: Five hundred and two (502) subjects aged above 40 years, obtained by a two-stage cluster sampling technique participated in this survey. Casual (random) plasma glucose estimations were done for all subjects after relevant personal data were obtained. Subjects with casual plasma glucose (CPG) > or =7.0 mmol/l had oral glucose tolerance tests (OGTT) done. Fasting and 2 h post glucose load blood samples were analyzed for plasma glucose levels. RESULTS: Thirty-four (34) subjects had diabetes, giving a crude prevalence rate of 6.8% (CI=4.6-9.0%), and standardized rate of 7.9%. The crude prevalence rates were 7.7 and 5.7% for males and females, respectively. Of the 34 diabetic subjects seen, 14 (41.2%) of them were not previously known to have diabetes; 83.7% of these were asymptomatic. Body mass index (BMI) > or = 25 kg/m2 and WHR > or = 0.85, family history of diabetes, physical inactivity, heavy consumption of alcohol, older age as well as high social status and Hausa-Fulani or Ibibio origin were associated with significantly higher prevalence of type 2 diabetes. CONCLUSION: The prevalence of type 2 diabetes in Port Harcourt is relatively high. Changing lifestyle associated with industrialization may explain this. A significant proportion of the diabetic subjects are asymptomatic and undiagnosed. The risk factors as shown in our study clearly emphasize the point that type 2 diabetes is to a large extent a preventable disease.
Abstract: OBJECTIVE: To devise a flowchart suitable for assessing risk of trichomoniasis, chlamydia and gonorrhoea in an adolescent population, not all of whom will be sexually experienced or currently in a relationship. METHODS: The data used to derive the flowchart were generated from cross-sectional microbiological surveys of girls aged 14-19 years in Port Harcourt, Nigeria. The flowchart screened on the basis of: (i) sexual experience; (ii) recent sexual activity; (iii) a positive urine leukocyte esterase (LE) test; and (iv) among LE negatives, a history of malodorous/pruritic discharge. FINDINGS: Using this flowchart, we found that 26.2% of all adolescents screened would receive treatment for cervicitis and vaginitis. Chlamydial, gonococcal, and trichomonal infections were correctly diagnosed in 37.5%, 66.7%, and 50% of the cases, respectively. CONCLUSION: Although the flowchart is more suitable for an adolescent population than the vaginal discharge algorithm used in syndromic management protocols, it still lacks precision and needs adapting to local settings.
Abstract: This study assessed the nutritional status of Nigerian adolescent girls living in two areas of south-eastern Nigeria. A cross sectional survey was undertaken in a rural village in Ogoniland, and five secondary schools in Port Harcourt, south-eastern Nigeria. All (386) menarcheal girls aged 14-19 y living in the rural village, and a stratified cluster sample (845) of menarcheal girls aged 14-19 in the five urban schools were investigated. Mean heights and weights of rural girls were around -1 Z-score below the British reference median. 10.4% of rural and 4.7% of urban girls were stunted (< OR =2nd centile, British 1990 reference values). After calculating mean body mass index-for-age, various cut-off points for low body mass index were tested. At a cut-off of < OR =9th centile, 15.6% of rural and 8.0% of urban girls would be classified as thin. Girls with a haemoglobin <10.Og/dl were significantly more likely to have a low body mass index than those with haemoglobin values > OR =10.0 g/dl. More studies are needed to refine the definition and interpretation of low body mass index in adolescents.
