Aspects épidémiologiques des enfants diabétiques perdus de vue à Abidjan / Epidemiological aspects of children with diabetes lost to follow-up at Abidjan

Introduction. Ces vingt dernières années, on assiste à une augmentation spectaculaire du nombre de cas de diabète de type 1 avec une mortalité plus élevée en Afrique Noire en lien avec les difficultés d'accès aux soins, à la rupture de suivi engendrant un nombre élevé de perdus de vue. L'objectif du travail est de déterminer le profil épidémiologique des enfants diabétiques perdus de vue dans notre pratique. Patients et méthodes. C'est une étude transversale à visée descriptive et analytique qui a concerné les enfants diabétiques perdus de vue de 2002 à 2019 dans le service de diabétologie du CHU de Yopougon. Résultats. Durant l'étude 195 enfants ont été suivi dans le service, 90 ont été considérés comme perdus de vue soit une fréquence de 46,15 %. L'âge moyen des perdus de vue était de 14,6 ± 5,3 avec des extrêmes allant de 2 à 20 ans. Ils sont majoritairement de sexe F dans 50,6 %. Dans 37 % on retrouve un niveau socio-économique faible calculé selon l'indice IPSE avec une association statistiquement significative entre les classes socio-économiques moyenneinferieure et moyenne (p respectivement < 0,01 et 0,001). La plupart des perdus (84,5 %) n'ont pas d'assurance maladie. Le lieu de résidence était urbain (Abidjan) dans 73 %. Ils ont issus d'une famille biparentale dans 79 ,8 % des cas. Une association statistiquement significative a été retrouvée entre la non-scolarisation et la perte de vue (P < 0,05).Conclusion. Le manque de suivi chez les enfants diabétiques a des conséquences drastiques sur le pronostic de la maladie au long cours, marqué par une mortalité de 11 % qui touche essentiellement les populations à revenu faible

Introduction. Over the past twenty years, there has been a spectacular increase in the number of cases of type 1 diabetes with a higher mortality rate in Black Africa due to difficulties in accessing care but also a lack of follow-up resulting in a high number of people being lost to follow-up. Our work aims to determine the epidemiological profile of diabetic children lost to follow-up. Patients and methods. This was a cross-sectional study with descriptive and analytical aims which concerned diabetic children lost to follow-up from 2002 to 2019 in the diabetes department of the University Hospital of Yopougon. Results. During the study period, 195 children were followed up in the department, 90 were considered as lost to follow-up, i.e. a frequency of 46.15%. The average age of the lost to follow-up was 14.6 ± 5.3 years with extremes ranging from 2 to 20 years. The majority of them were male (50.6%). Thirty-seven percent had a low socioeconomic level calculated according to the IPSE index, with a statistically significant association between the lowermiddle and middle socioeconomic classes (p < 0.01 and 0.001 respectively). Most of the lost (84.5%) did not have health insurance. The place of residence was urban (Abidjan) in 73%. They came from a two-parent family in 79.8% of cases. A statistically significant association was found between non-education and loss of sight (P < 0.05). Conclusion. The lack of follow-up in diabetic children has drastic consequences on the prognosis of the disease in the long term marked by a mortality of 11% which affects mainly low-income populations.

Socioecological analysis of determinants of early adolescent sexuality in Benin: a qualitative study

Introduction: early adolescent sexuality is associated with an increase in risky sexual behaviour, unwanted pregnancies, and the occurrence of sexually transmitted infections. However, despite the efforts of governments and their partners, the implementation and effectiveness of appropriate and adapted services to improve adolescent sexual and reproductive health are lagging. Therefore, this study aimed to document determinants of early adolescent sexuality in the central district of Tchaourou in Benin based on a socio-ecological approach. Methods: an explorative and descriptive qualitative study was conducted using focus groups and individual interviews based on the socio-ecological model. Participants included adolescents, parents, teachers, and community leaders in Tchaourou. Results: the number of participants in each focus group was 8 (32). There were 20 girls and 12 boys aged 10-19 years, of whom 16 were students (7 females and nine males) and 16 were apprentice dressmakers and hairdressers. In addition, five participants attended individual interviews (two community leaders, one religious' leader, one teacher and one parent). Four themes were identified that influence early sexuality among adolescents and grouped into individual determinants related to knowledge about early sexuality; interpersonal determinants related to adolescents' function, including the influence of family and peers; community and organizational determinants related to where harmful sociocultural norms; political determinants comprising the disadvantaged socioeconomic status of the communities where adolescents live. Conclusion: many factors at multiple social levels influence early adolescent sexuality in the commune of Tchaourou in Benin. Therefore, interventions directed at these various levels are needed urgently.

Psychosocial consequences and reasons for illicit drug use among police officers in a northern Nigerian city: A mixed-method study

Harmful use of drugs is one of the principal risk factors affecting population health worldwide. Chronic use has been linked to medical, psychological and socioeconomic consequences. This study assessed the psychosocial consequences and reasons for illicit drug use among police officers in Kano, Nigeria. Using a mixed method of data collection, quantitative data was obtained from a cross-section of 275 officers using the Shortened Inventory of Problems-Drug Use (SIP­DU) and a pretested adapted questionnaire. In-depth interviews with 10 officers who used illicit drugs provided additional information. Almost half of the respondents (46.5%, n=128) were in their fourth decade of life with a mean age (±SD) of 35.1 ± 7.7 years. Over a quarter of the respondents (n=75) reported ever using illicit drugs, out of which 14.9% (n=41) were current users. Among the current drug users, 80.5% (n=33) attested to having money problems, 61.0% (n=25) agreed that they had spent too much money, and 56.1% (n=23) failed to do what was expected of them as a result of drug use and have hurt their family. Helping to stay awake and improving confidence were the major reasons (100%, n=41) for drug use mentioned by the respondents. The Nigerian Police Force should look into easing shifts and introducing stress-relieving activities. There is also the need to strengthen substance education and counselling and support officers with confidence issues, sleep disorders, and treat those with mood disorders.

Socio-economic status as predictors of malaria transmission in KwaZulu-Natal, South Africa. A retrospective study

Background: Understanding the socioeconomic status that influences malaria transmission in KwaZulu-Natal, South Africa is vital in creating policies and strategies to combat malaria transmission, improve socioeconomic conditions and strengthen the malaria elimination campaign. Objectives: To determine the relationship between socioeconomic status and malaria incidence in KwaZulu-Natal, South Africa. Methods: Socioeconomic information (gender, age, no formal education, no electricity, no toilet facilities, unemployment) and malaria data for 2011 were obtained from Statistics South Africa and the malaria control program of KwaZulu-Natal, South Africa respectively. The analysis was conducted employing the Bayesian multiple regression model. Results: The obtained posterior samples show that all the variables employed in this study were significant and positive predictors of malaria disease at 95% credible interval. The low socioeconomic status that exhibited the strongest association with malaria risk was lack of toilet facilities (odd ratio =12.39; 95% credible interval = 0.61, 24.36). This was followed by no formal education (odd ratio =11.11; 95% credible interval = 0.51, 24.10) and lack of electricity supply (odd ratio =8.94; 95% credible interval = 0.31, 23.21) respectively. Conclusions: Low socioeconomic status potentially sustains malaria transmission and burden. As an implication, poverty alleviation and malaria intervention resources should be incorporated side by side into the socioeconomic framework to attain zero malaria transmission.

Staff risks stratification in preparation for COVID-19 in a tertiary healthcare facility in Nigeria

Introduction: this report is a documentation of a staff risk stratification programme, undertaken in University of Benin Teaching Hospital, with outcomes, and the actions taken to protect staff. Methods: an adapted risk stratification tool was circulated to all staff through their respective heads of departments/units. Staff were expected to voluntary assess their health and risk status in the context of COVID-19, using the tool. A central multi-disciplinary screening committee assessed submissions and invited staff who required further evaluation for physical interviews. Respondents were categorized into three risk/exposure groups from lowest to highest - A, B, and C, based on their individual health assessments, occupational exposures, and information obtained from direct interviews. Results: the committee received submissions from 746 staff, representing 19.4% (about a fifth) of the hospital's 3,840 staff. One hundred and twenty two of these were invited for physical interviews, of whom 88 (72.1%) were categorized as high risk (Category C): pregnancy (53.4%); bronchial asthma (19.3%); hypertension (11.4%); cancer (3.4%) and sickle cell disease (2.3%); fractures and pulmonary tuberculosis (1%, respectively). These staff were recommended for redeployment from areas of high risk exposure to COVID-19. Conclusion: a management-driven risk assessment of hospital staff in preparation for the COVID-19 pandemic revealed that a fifth of staff assessed themselves as being vulnerable to adverse outcomes from exposure. It is our hope that similar risk stratification programmes will become standard practice in healthcare facilities during disease outbreaks, especially in Africa

Socioeconomic status and health shocks; analysis of coping strategies in rural households of Enugu State, Nigeria

Background: Health burden in rural areas of developing countries is worsened by the limited coverage of health insurance. With constrained access to quality healthcare and constituting two thirds of Nigeria's poor, this study investigates how rural households cope with health shocks consequent on their socioeconomic status. Method: Data was collected from 600 households in Enugu using a questionnaire. Cross-tabulation, chi square and multiple regression statistical techniques were employed for data analysis. Findings: About 53% of the respondents were male household-heads while borrowing (47.65%), sales of assets (43.85%), diversion of funds (2.00%) and reduced expenditure (6.48%) were the main coping strategies. Education, occupation, and income statistically influenced the coping strategies (P < 0.005) and jointly accounted for 26.5% (R2 = 0.265, P < 0.001) of the variations in coping strategies. Conclusion: Having a rural healthcare policy and mainstreaming the informal sector into the national health insurance scheme will am

Relationship of combined frequency of hypertension and diabetes mellitus to socioeconomic status: A comparative study in Anambra State of Nigeria

There are conflicting reports on the relationship between hypertension and diabetes mellitus (DM) with socioeconomic status. This study explores this relationship individually and jointly. This is a cross sectional comparative study. Adults that participated in medical outreach organized for high and low socioeconomic status (SES) were tested for hypertension and DM. Mean age in years for high and low SES was 58.69 (± 10.26) and 57.77 (± 15.54), respectively. Widows were significantly more than widowers (P < 0.001). Frequency of hypertension in middle age (45 to 64 years in high and low SES) was 58.0 and 71.9%, respectively (P = 0.009). Frequency of DM was 19.2 and 7.3% in high and low SES respectively (P < 0.001). Combined frequency of hypertension and DM was 14.0 and 6.0% in high and low SES respectively (P = 0.002) and 13.8 and 5.9% in the middle age group in high and low SES respectively (P = 0.034). Severity of hypertension was more in low than high SES (P = 0.001). The prevalence and severity of hypertension among middle age in low SES is higher than in high SES. Combined frequency of hypertension and DM is more in high than low SES

Awareness of stroke risk factors and warning symptoms amongst hypertensive patients in Benin city

Background: Hypertension is the most important modifiable risk factor for stroke. Satisfactory participation in stroke preventive measures depends on stroke knowledge. The aim of this study was to determine the level of stroke awareness amongst hypertensive patients. Methods: A cross-sectional study with one hundred and forty-four hypertensive patients consecutively recruited and interviewed for stroke awareness. Six variables, age, gender, educational status, marital status, socio-economic status, and blood pressure recording were included in three multiple logistic regression models. The dependent variables were knowledge of organ affected, knowledge of risk factors and warning symptoms of stroke. Results: The male sex and increased educational status were predictive of good stroke awareness, while increasing age and poor blood pressure control are predictive of poor stroke awareness. Conclusion: The older hypertensive patient whose blood pressure is uncontrolled is at significant risk for stroke, but unfortunately has poor awareness of stroke. This group should be a target for stroke knowledge campaign

A Cross-Sectional Study of Socioeconomic Status and Cardiovascular Disease Risk among Participants in the Prospective Urban Rural Epidemiological (PURE) Study

Background. Cardiovascular diseases (CVDs) are a challenge to populations and health systems worldwide. It is projected that by 2020 about a third of all deaths globally will be caused by CVDs; and that they will become the single leading cause of death by 2030. Empirical evidence suggests that there is socioeconomic patterning in the distribution and prevalence of risk factors for CVD; but the exact nature of this relationship in South Africa remains unclear. Objective. To examine the association between socioeconomic status (SES) and risk factors for CVD in a cohort of adult South Africans living in rural and urban communities.Method. This was a cross-sectional analytical study of baseline data on a population-based cohort of 1 976 SA men and women aged 35 - 70 years who were part of the Cape Town arm of the Prospective Urban and Rural Epidemiology (PURE) Study.Results. We found a complex association between SES and CVD risk factors; its pattern differing between urban and rural participants. Marital status showed the most consistent association with CVD risk in both groups: widowed participants living in urban communities were more likely to be hypertensive as well as diabetic; while single participants in both locations were more likely to use alcohol and tobacco products. Level of education was the only SES variable that had no significant association with any CVD risk factor in either study group. All measured SES variables were significantly different between urban and rural participants (p0.05); with diabetes; obesity and alcohol use significantly more prevalent in urban than in rural participants (p0.05) while hypertension and tobacco use were not (p?0.05). Conclusions. In this cohort of South Africans; there were significant associations between SES and CVD risk; with marked differences in these associations between rural and urban locations. These findings highlight the need to consider SES and area of residence when designing interventions for CVD prevention and control

Pattern of Asymptomatic Bacteriuria among Pregnant Women Attending an Antenatal Clinic at a Private Health Facility in Benin; South-South Nigeria

"Background/Objective: The objective was to establish the characteristics of antenatal attendees in Faith Medical Centre; a private health facility in Benin City who have asymptomatic bacteriuria (ASB) as well as to determine the relationship between ASB and socioeconomic status.Methods: It was a descriptive; cross-sectional study involving 240 pregnant women who presented in the course of antenatal care from January to April 2009. With the aid of a questionnaire patients who were recruited for the study had their socio-demographic data and relevant gynecological and drug history recorded. A physical examination was done to document temperature; height; weight and symphysiofundal height. A clean-catch midstream urine sample was collected for microscopy and culture. White blood cell count of?5/hpf and/or bacteria count of?1/hpf of urine was considered significant for urine microscopy and a single colony count of ?105/ml from two consecutive urine samples was considered significant for urine culture.Results: The prevalence of ASB was 13.8 by urine culture and 43.8 by urine microscopy among antenatal attendees in Faith Medical Centre; Benin City. There was no relationship between ASB and socio-economic factor (P value=0.1267). There was also no significant specific trend between ASB and age (P value=0.0578). Using urine culture as gold standard; the sensitivity of urine microscopy was 90.9; the specificity was 49.3; the positive predictive value was 22.2 and the negative predictive value was 97.1.Conclusion: ASB in pregnancy is common in Faith Mediplex and has no statistically significant relationship with socioeconomic status. The current practice of diagnosing and treating ASB based on urine microscopy needs to be reviewed since the specificity of urine microscopy is very low. Also the practice of screening pregnant women only at the time of booking can lead to under-diagnosis of ASB. This is so because most women who develop this condition later in the course of antenatal care will be missed."""

Enteropathogens Associated with the Seasonal Fluctuations in Plasma Sodium and Potassium Levels in Childhood Diarrhoea

This paper aims to assess the clinical; nutritional; microbiological; environmental and socio-economic determinants that have a seasonal distribution; or are potential confounders of a seasonal association of previously described seasonal fluctuations in plasma sodium and potassium concentrations in children with dehydrating diarrhoea. A cross-sectional analytical study was conducted from 15 April 2002 to 14 April 2003 of 350 children aged six weeks to two years admitted to the diarrhoea rehydration unit of a children's hospital in Cape Town. Multiple linear regression analysis showed the plasma sodium levels to be statistically significantly associated with age [-0.3 mmol/l per month of age; 95 confidence interval (CI): -0.2; -0.4]; enterotoxigenic Escherichia coli infection [-2.1 mmol/l; 95 CI: -4; -0.2]; enteropathogenic E. coli infection [-5.1 mmol/l; 95 CI: -7.1; -3.1]; being breastfed [1.9 mmol/l; 95 CI: 0.4; 3.4] and living in a brick house [2.7 mmol/l; 95 CI: 0.8; 4.5]. Plasma potassium levels were associated with duration of diarrhoea before admission [-0.02 mmol/l per day of diarrhoea; 95 CI: -0.01; -0.04]; cryptosporidium infection [-0.3 mmol/l; 95 CI: -0.1; -0.6] and parental education [0.04 mmol/l per year of education; 95 CI: 0.1; 0.01]. Of these; enterotoxigenic and enteropathogenic E. coli and cryptosporidium infections followed seasonal distributions that were similar to those of the electrolyte concentrations. Seasonal fluctuations in plasma sodium and potassium levels are at least partly explained by both enterotoxigenic E. coli and cryptosporidium infections working together. Enterotoxigenic E. coli infection has a larger effect on plasma sodium levels and cryptosporidium infection has a larger effect on plasma potassium levels

Characteristics of Women Having First-Trimester Termination of Pregnancy at a District Hospital in Kwazulu-Natal

Termination of pregnancy (TOP) is requested by some women for a variety of reasons and it is plausible that profiling their characteristics might help to target selected groups for counselling. This study aimed to determine the characteristics of women having a legal first-trimester TOP at a regional hospital in KwaZulu-Natal. The medical records of 254 women were retrospectively sampled and analysed from a total of 758 women who had a first-trimester TOP between January and December 2008. The women were aged 14-45 years (the most common age group was 20-29 years; a mean age of 25.3 years and a standard deviation of 5.9). The majority (75.6) reported that they had at least one child who was alive; 1.6 had previously had a TOP; 93.3 were single and 28.4 resided outside the health district in which the hospital was situated. Eighty-nine per cent had not used contraception before the index pregnancy. Fifty-eight per cent requested a TOP between 9 and 12 weeks of gestation (a mean of 8 weeks). Ninety-six per cent had a TOP because of socio-economic reasons. All of the women received counselling prior to undergoing TOP. In our patient population; women who had a legal TOP in the first trimester were in their twenties; single; parous; sexually active; not on a contraceptive and of poor socio-economic status. Women with these characteristics should be targeted for appropriate counselling on reproductive health matters

Influence of Parental Socioeconomic Status on Caries Prevalence among Children Seen at the University College Hospital; Ibadan

Background: Dental caries is a lifetime disease and its sequelae have been found to constitute health problems of immense proportion in children. Environmental factors such as culture; socioeconomic status; lifestyle and dietary pattern can have a great impact on cariesresistance or caries-development in a child. Objective: The present study was conducted to evaluate the relationship between dental caries and socioeconomic status of children attending paediatric dental clinic in UCH Ibadan. Methods: Socio-demographic data for each child that attended paediatric dental clinic; UCH Ibadan within a period of one year was obtained and recorded as they presented in the dental clinic; followed by oral examination for each of them in the dental clinic to detect decayed; missing and filled deciduous and permanent teeth (dmft and DMFT respectively). Results: The mean dmft and DMFT score for the 209 children seen within period of study were 1.58 + 2.4 and 0.63+1.3 respectively. Highest caries prevalence (46.9) was found within the high social class while the caries prevalence in middle and low social class were 40.5 and 12.6 respectively. The highest dmft/DMFT of 7 was recorded in two children belonging to high social class. The difference in dmft in the three social classes was statistically significant (x 2 = 51.86;p= 0.008) but for DMFT; it was not statistically significant (x2 = 6.92; p = 0.991).Conclusion: Caries experience was directly related to socio-economic status of the parents of the studied children with highest caries prevalence in high and middle socioeconomic classes

Sociodemographic Factors in Anaemia in Pregnancy in South-Western Nigeria

Background: Anaemia in pregnancy persists; especially in third world countries where poor diet; low levels of literacy; infections; infestations and cultural practices predispose pregnant women to being anaemic. The aim of this study was to determine the prevalence of anaemia in pregnancy and to identify the possible associations between socio-economic status and anaemia in pregnancy among antenatal care seekers at Baptist Medical Centre; Ogbomoso; Oyo State; Nigeria.Method: A total of 350 pregnant women were recruited at booking from the antenatal clinic of the hospital. A standardised questionnaire was administered to collect sociodemographic data. The subjects were stratified into upper; middle and lower socio-economic groups according to a scoring system designed by Olusanya et al. for Nigeria and other African countries. Anaemia is defined as a haemoglobin level of less than 11 g/dl by the World Health Organization.Results: The prevalence of anaemia in pregnancy was 58.0 in the study population. Anaemia prevalence was significantly higher among the subjects in the middle and lower socio-economic classes: 78.3 respectively (P 0.05). The majority of the severely anaemic subjects (80.0 and 80.3) were from the lower social class.Conclusion: The prevalence of anaemia in pregnancy was found to be high in this population. Low socio-economic status is significantly associated with increased prevalence and severity of anaemia. It is recommended that the socio-economic situation of women be improved. This no doubt will help to reduce anaemia in pregnancy

Socioeconomic Status and Barriers to the Use of Free Antiretroviral Treatment for HIV/AIDS in Enugu State; South-Eastern Nigeria

With about 3 million people living with HIV; Nigeria has approximately 8of the global burden of HIV cases. In 2009; only about 34of those in need of antiretroviral treatment (ART) were able to access care; which means that Nigeria was far from achieving the United Nations target of `universal access' by 2010. This study aimed to describe the barriers to accessibility and the coping strategies employed to overcome these barriers among users of free ART services overall and by socioeconomic status (SES). Data were collected from 240 people receiving ART at one urban and one peri-urban health facility in Enugu State; south-eastern Nigeria. Information on SES; demographic characteristics; and barriers and coping mechanisms for accessing ART were elicited from the respondents. The high cost of transportation; HIV stigma; and long waiting hours were found to be key barriers to the use of ART services. On average; ART clients spent just under four hours at the clinic during their monthly appointments. The use of personal savings and financial support from relatives were the main means to access treatment. When the data were analysed according to clients' SES; transportation costs were a chief concern among the poorest while those who were better off were more likely to be concerned about stigma and discrimination. These findings should be borne in mind when designing and locating services to maximise ongoing accessibility to ART

The Effects of Gender and Socioeconomic Status on Youth Sexual-Risk Norms: Evidence from a Poor Urban Community in South Africa

HIV and AIDS remains one of the most serious problems facing youths in many sub-Saharan African countries. Among young people in South Africa; gender is linked with a number of HIV-risk behaviours and outcomes. The literature suggests that factors such as socioeconomic status; intimate partner violence; and several psychosocial factors contribute to gendered differences in sexual behaviour among youths in South Africa. However; the existing body of literature scarcely addresses the interaction between gender; confounding factors (particularly peer norms) and sexual behaviour outcomes. This study uses a survey design (n = 809) to examine how gender and socioeconomic status moderate the effects of norms and attitudes on higher-risk sexual behaviours among secondary school learners in a low-income community in South Africa. The findings suggest that gender interacts significantly with peer norms to predict sexual behaviour. Peer norms and the experience of intimate partner violence were significantly associated with sexual risk behaviour among girls participating in the study. The article discusses both the wider implications of these findings and the implications for school-based and peer-facilitated HIV interventions

Socioeconomic Status and Self-Reported Tuberculosis: a Multilevel Analysis in a Low-Income Township in the Eastern Cape; South Africa

Few studies have investigated the interplay of multiple factors affecting the prevalence of tuberculosis in developing countries. The compositional and contextual factors that affect health and disease patterns must be fully understood to successfully control tuberculosis. Experience with tuberculosis in South Africa was examined at the household level (overcrowding; a leaky roof; social capital; unemployment; income) and at the neighbourhood level (Gini coefficient of inequality; unemployment rate; headcount poverty rate). A hierarchical random-effects model was used to assess household-level and neighbourhood-level effects on self-reported tuberculosis experience. Every tenth household in each of the 20 Rhini neighbourhoods was selected for inclusion in the sample. Eligible respondents were at least 18 years of age and had been residents of Rhini for at least six months of the previous year. A Kish grid was used to select one respondent from each targeted household; to ensure that all eligible persons in the household stood an equal chance of being included in the survey. We included 1020 households within 20 neighbourhoods of Rhini; a suburb of Grahamstown in the Eastern Cape; South Africa. About one-third of respondents (n=329; 32) reported that there had been a tuberculosis case within the household. Analyses revealed that overcrowding (P=0.05) and roof leakage (P= 0.05) contributed significantly to the probability of a household TB experience; whereas higher social capital (P=0.01) significantly reduced this probability. Overcrowding; roof leakage and the social environment affected tuberculosis prevalence in this economically disadvantaged community. Policy makers should consider the possible benefits of programs that deal with housing and social environments when addressing the spread of tuberculosis in economically poor dist

The Prevalence and Perception of Obesity and its Association with the Lifestyle of Women at the Mangaung University Community Partnership Project Healthcare Centre; Bloemfontein

Background: This investigation was prompted by the increase of obesity in developing countries with the simultaneous increased risk of preventable noncommunicable diseases. We aimed to determine the prevalence of obesity among women serving a predominantly black peri-urban community; who visited a healthcare centre in Bloemfontein. We also wanted to establish their perceived weight status; and any correlation between obesity; level of education; employment status and monthly income.Method: A cross-sectional analytical design was used. In June 2007; clinic-attending women aged 18-50 years were selected by a systematic sampling method to participate in the study. A self-administered questionnaire investigated participants' socio-economic status; body image perception; psychological well-being; self-reported health status and physical activity. Body mass indices (BMIs) were calculated from weight and height measurements.Results: A total of 304 women completed the study; of whom 98 (32.2) were overweight and 134 (44.1) were obese; with a mean BMI of 30.1 kg/m2 [standard deviation (SD) 6.9 kg/m2]. More than half (53.4) of the obese women perceived themselves as not obese. Approximately 84 of the participants were educated to secondary level; or higher. A significant difference in the employment status of the obese and non-obese participants (26.9and 16.5 employed; respectively) was noted (p-value = 0.0013). The obese participants reported significantly less low self-esteem (29.5) than the nonobese participants (42.4) (p-value = 0.0250).Conclusion: The high prevalence of overweight and obesity; and the fact that 53.4 of the obese participants did not perceive themselves as such; poses a challenge for healthcare providers. Health-promotion strategies should aim to inform women about the health risks of overweight and obesity; and address misconceptions regarding perceived weight status

Social Aspects of Malaria among Students in Two Tertiary Institutions in Lagos; Nigeria

Studies were carried out on the social aspects of malaria among 600 students. Three hundred students (150 male; 150 females) were randomly selected from two tertiary institutions in Lagos; Nigeria. These schools are Lagos State University (LASU) and AOCOED (Adeniran Ogunsanya College of Education). A structured questionnaire elicited relevant information on knowledge; perception and social aspects of malaria. Students aged 21-23; from faculty of arts and in their second year participated mostly in the study with no significant difference between the two schools. In LASU; 223(74.3) and 211(70.3) in AOCOED knew the cause of malaria (P0.05). In LASU; 282(94) and 192(64) in AOCOED believed that malaria could be prevented (P0.05). In LASU; 283(96) and 283(94.3) in AOCOED believed malaria could be treated (P0.05). 109 (36.3) respondents in LASU and 112(37.3) in AOCOED thought that malaria was contagious (P0.05). Fever was the most recognised symptom of malaria in both schools and self-medication was more popular in AOCOED. In LASU; 284(94.6) and AOCOED; 273(91) had malaria in the past one year (P0.05). 146(48.7) of the students who participated in LASU and 206(68.6) in AOCOED had been admitted for malaria within the past one year (P0.05). Class absenteeism and low academic performance were significantly higher in AOCOED than LASU. However; our results suggested that the LASU students were more informed about malaria than the AOCOED students because their knowledge and perception was better. The students; despite their academic backgrounds need intensified health education on malaria incorporated into their schools' curriculum

Relationship between parental socio-economic status and casual blood pressure in coastal nigerian adolescents

BACKGROUND: Emerging data suggest that essential or primary hypertension occurs in the young. Parental socioeconomic status may play a role but the exact mechanisms still remain unclear. OBJECTIVE: This study was aimed at determining the relationship between parental socioeconomic status and casual blood pressure in adolescents. METHODS: One thousand and eight adolescents attending two secondary schools in Calabar; Nigeria were selected by stratified random sampling. Their blood pressure; weights and heights were taken using standard methods and sociodemographic data were obtained using a pretested semistructured questionnaire. RESULTS: Blood pressure was increased with age with males having higher values. The other major determinants of blood pressure were weight; height; body mass index; level of physical activity and parental socioeconomic status (p 0.05). Female adolescents with parents in the lower socioeconomic classes had significantly higher systolic and diastolic blood pressure (p 0.05). In contrast; parental socioeconomic status showed no significant relationship with systolic blood pressure and diastolic blood pressure in males (p 0.05).The prevalence of elevated blood pressure was higher in females than in males. CONCLUSION: Low parental socioeconomic status appear to be associated with higher casual blood pressure especially in female coastal Nigerian adolescents. Traditional determinants did not appear to play a significant role. Psychological stress arising from environmental and economic stressors may be responsible