Behavioural problems among schoolchildren in Nigeria

Background: Behavioural problems among schoolchildren can pose a burden on families and society. Objective: To determine the prevalence and pattern of behavioural problems among children living in Uyo, a town in South-South Nigeria. Methods: A cross-sectional study was carried out among 572 pupils from six primary schools selected randomly from private and government schools in Uyo. Pupils with a normal IQ were selected using a systematic sampling method. The Rutter behavioural scale for teachers (B2) was completed by their teachers, and that for parents (A2) was completed by the parents. Student's t-test was used to compare pairs of means, frequencies were compared using the chi-square test, and p<0.05 was taken as significant. Results: According to the teachers' scale 132 pupils (23.1%) had scores within the range indicating behavioural problems, compared with 103 pupils (18.0%) on the parents' scale. This was statistically significant (χ2=19.8, p=0.001). Pupils in government and private schools had mean scores of 7.4 (standard deviation (SD) 6.41) and 5.12 (SD 6.26) and 7.29 (SD 5.84) and 6.96 (SD 5.76), respectively. Behavioural problems were more common among children in government schools and among those in the lower socio-economic class. Boys had significantly higher mean scores than girls, and both scales showed more boys to be disturbed. Antisocial behaviour was commonest among boys and older children. Conclusion: There is a high prevalence of behavioural problems among primary school children in Uyo, with a predominance of antisocial behaviour. The government needs o provide appropriate services to deal with this state of affairs

Review of Obstetrics Genito-urinary Fistulae in the University of Calabar Teaching Hospital Calabar; Nigeria

Obstetric fistulae with Urinary incontinence are one of the most distressing maternal morbidities. It is associated with physical and social deprivation such as wife abandonment and violent reactions against the victims particularly in the developing countries of the world. To study the demographic and reproductive profiles as well as management of patientswith obstetric fistulae inUCTH;Calabar;Nigeria. Afiver-year retrospective study of case records of 37 patients managed inMaternity Annex of University of Calabar Teaching Hospital; Calabar Nigeria for obstetric genito-urinary fistulae was carried out. One in every 122 parturients during the period had fistula. Eleven (29.7) were teenagers. Many patients weremarried (54.1); nulliparous (59.4); come from low socioeconomic class (72.9) and did not utilize modern obstetric facilities properly. Many cases resulted from prolonged obstructed labour (51.4) and 70.2presented with total incontinence of urine. Eighteen (48.7)were diagnosed within 6 month of delivery. Themain types encountered includedwere vesico-vaginal (34.4) or complex (10.8) fistulaewho were manage conservatively (21.6) or with bladder repairs. Majority (29.7) were referred for further treatment. Parturient in Calabar still suffer from this age long obstetric morbidity mainly due to poor utilization of modern obstetric care facilities. Results of treatment are largely unsatisfactory; therefore resources should be channeled towards prevention

Clinical Presentation and Complications in Patients with Unsafe Abortions in University of Calabar Teaching Hospital; Calabar; Nigeria

Background: Unsafe abortion still contributes significantly to high maternal morbidity and mortality particularly in developing countries despite concerted efforts being made to reduce it. Our objective is to determine the incidence; mode presentation and complications of Unsafe abortion. Method: This prospective study was carried out by directly interviewing patients managed for unsafe abortion over one and half years period (1st June 2003; to 31st December; 2004) in Maternity Annex of the University of Calabar Teaching Hospital Calabar; Nigeria. Results: Incidence of Unsafe abortion of 27.6of all gynaecological admissions was established. Most Patients (55.7) were age 20 30 years while 25.4were teenagers. There were 33 (27.1) students; 38.2were single women and 38.5had secondary education. The major reasons given for terminating the pregnancy included completion of education (25.4); fear of parental action (18.8) and in 17.2the father of the pregnancy was unknown. Medical officers (32.8) performed majority of the abortions while 10.7were self induced by the patients themselves. Main complications encountered included retained product of conceptions; haemorrhage; sepsis; injuries to genital tracts and intraabdomal organs. Conclusion: Unsafe abortion and it complications occurs in all socioeconomic groups. Efforts directed at reducing unintended pregnancy by comprehensive family planning programs and effective emergency post abortal care services will reduce the problem while the legal status of abortion is being debated

Infertility among Nigerian Couples as seen in Calabar

Objective: This study was conducted to determine the infertility pattern among Nigerian couples in Calabar and to examine the outcome of our management strategies.Methods: A retrospective descriptive design study based on findings from the clinical files of infertile couples presenting at the gynaecology and the male fertility clinics of University of Calabar Teaching Hospital over a five-year period (2001-2005). Data were collected from all the documented clinical and laboratory findings.Results: The obvious causes of infertility constituted 58in females; 30in males and 12in both partners. Primary infertility was found in 69.7of males and 34.5of females and secondary infertility in 30.3of males and 65.5of females. Infection appears to be a strong predisposing factor to infertility in both male and female patients in our study population. Pregnancy was achieved in 24of our female patients who had tubal surgery; while 69of our males who had varicocelectomy had improvement in seminal fluid parameters.Conclusion: Prevention and prompt treatment of infection; particularly the sexually transmitted infections could be beneficial in the reduction of infertility among couples

Sexual behaviour; HIV-related knowledge and condom use by Intra-City commercial bus drivers and motor park attendants in Lagos; Nigeria

"A study was undertaken among 395 intra-city commercial bus drivers; conductors and motor park attendants in a sub-urban community in Lagos; Nigeria. It was aimed at ascertaining the level of knowledge of the participants on sexually transmitted diseases including AIDS; their sexual practices and perceived vulnerability to these diseases and; in particular; their attitude to and use of condoms. A semi-structured interview schedule was used for data collection. The men were found to have a strongly woven network of sexual relationships. Their sexual network included; apart from their wives and regular partners; commercial sex workers; young female hawkers; schoolgirls; and market women within and outside the motor parks. More than two thirds (74.3 ) of the men had multiple sex partners and many of them had had sexually transmitted diseases at one time or another. Condom ever-use rate was 65.6 but consistent and regular use rate with casual partners was 11.6 . Almost all the respondents (96.4 ) knew themselves to be at high risk of contracting STDs; while 87.6 felt that it was impossible for them to ""catch"" AIDS. Poor knowledge of risk factors for STDs was exhibited; as many of them attributed their previous STDs to excessive exposure to the sun; having sex in the sun; and their partners remaining in the bath for too long. Intra-city commercial bus operators and men at motor parks are a high risk group for acquiring HIV infection. Their sexual networking with a variety of women within and outside the parks also seems to suggest that they play a major role in transmitting HIV infection in urban communities in Nigeria. There is a need for intervention programmes with a focus on men at motor parks and similar high risk groups."

Factors Responsible for Domestic Water Contamination

Many deaths occurring in the developing countries are due to water borne diseases which are usually associated with water related behaviour such as improper disposal of faecal material as well as improper storage of water. This study was therefore designed to identify the factors that influenced domestic water contamination in our rural communities and recommend some intervention measures that can reduce this high morbidity and mortality due to diarrhoeal diseases in Nigeria. Water samples from the water sources serving six rural communities in three local government areas of Lagos State as well as water samples from 308 households from the six communities were collected for bacteriological examination. Demographic and socio-economic characteristics; toilet facilities and water storage facilities available in the households were recorded in a structured questionnaire and analysed with X2 and ANOVA statistical packages. Two out of the 12 (16.7) water sources (both bore-holes); were potable and the others were contaminated with feacal bacteria. A low percentage of households in each of the six communities had potable drinking water. Many toilets facilities (42.9) were situated less than 10 meters away from the households. Only a few households (6 .1 ) purified their drinking water. The water source; toilet facilities and occupation of the fathers in the households had a statistically significant positive association (p0.05) with the domestic water contamination level whereas age; level of education and overcrowding did not. The study recommends provision of less contaminated sources of water such as boreholes as a source of supply to communities and introduction of programmes that will promote hygienic practices amongst the communities

Recurrent erythema multiforme

The case of a three-and-half year old male child with the severe form of erythema multiforme (EM) major (Stevens-Johnson syndrome) is described. From the past medical history; the child had seven previous attacks of a similar disease in the immediate past 24 months. The first four attacks of the disease were considered; by their description; to be mild EM minor; as the lesions were limited to the skin; while the next four recurrences; including the present one; were regarded as severe; with extensive involvement of the skin; mucosae of the mouth; nose; eyes and urethral orifice; that required hospitalization