Utilization of Secondhand Childcare productsand Perceived Health Risks among Mothers of Under-Five Years Children in Ibadan Metropolis, Nigeria

Background: Second-hand economy is a universal phenomenon. In Nigeria, it cut across many decades and all spectrums of life even in childcarepractice. The role of second-hand products in childcare practice and provisioning has been under reported in scholarly discuss in Nigeria. Hence,the prevalence of secondhand childcare products utilization, different categories of secondhand products available for childcare, the perceived health hazards and the reasons why consumers patronize secondhand products for childcareamong mothers of under five years in Ibadan Nigeria.Methods:A cross sectional concurrent mix-methods approach was used in the study. The quantitative and qualitative data weredone simultaneously. While mothers of under-five children were purposively selected for in-depth interviews, a total sampling of all consenting mothers of under-five found at immunization clinic of Primary health care centres were sampled for survey. A total number of 403 mothers of under five children participated in the survey while 50 IDIs were conducted with buyers (mothers) and traders of secondhand children's products. Qualitative data were subjected to thematic analysis, while the quantitative data were analyzed with descriptive statistics and chi-square test.Results:The mean age of mothers is ± SD 28.6 ± 5.4. Majority of respondents 209 (51.9%) had senior secondary education, 140 (34.7%) had tertiary education and only 2 (0.5%) had no formal education. About 339 (84.1%) utilized secondhand childcare products, while 64 (15.9%) never used secondhand childcare products. Mothers with at least senior secondary education 209 (51.9%) were found to be the highest users of secondhand childcare products. Procurement and utilization of secondhand childcare products was based on quality value, availability, affordability attached to constructed superiority of western civilization wrapped around provisioning in childcare. Conclusion: Many mothers of under-five children in Ibadan utilizes secondhand products in childcare. Embedding secondhand products health hazard in health talk during immunization clinics will be beneficial and help in educating mothers on reduced and safe utilization of secondhand products in childcare

Development of the African Digital Health Library (ADHL): Experience at the Medical Library, University of Ibadan, Nigeria

The African Digital Health Library, (ADHL) is a collaborative project involving five African institutions namely Bamako University of Science and Technology, Kenya Methodist University, Universities of Ibadan, Nairobi, Zambia, and Zimbabwe. The University of Ibadan Nigeria component of the ADHL (ADHL-UI) is described in this paper. Funded by the Office of Global AIDS Coordinator of the United States Department of State, the goal of ADHL-UI is to store, preserve, make accessible through an institutional repository, theses and dissertations by postgraduate students of the institution's College of Medicine. The ADHL-UI has over 1000 theses and dissertations accessible on the internet. Creation of the ADHL-UI, a repository of theses and dissertations in the Medical Library, University of Ibadan, is a major contribution to research development and preservation of institutional scholarly heritage. Effective use by students and faculty will help in reducing duplication of research efforts and create visibility for the authors and the institution.

Prevalence and pregnancy outcomes in patients with antepartum haemorrhage in a tertiary hospital in Ibadan, Nigeria

Background: Antepartum haemorrhage (APH) as one of the major obstetric emergencies contributing greatly to maternal and fetal morbidity and mortality is of serious concern in the developing world. A retrospective analysis of the APH cases and evaluation of its impact on fetal and maternal outcomes was conducted.Methods: A retrospective study of cases managed between January 2013 and December 2014 at the University College Hospital Ibadan; all cases at a minimum of 28 weeks of gestation with antepartum bleeding were selected. Data was retrieved from the hospital records.Results: Around 5.8% prevalence rate of APH was documented during the study period with placental abruption and placenta praevia accounting for 46.8% and 39.2% of these cases respectively. Only 28.5% of cases were booked. Three-fifths of the women had anemia, 17.7% suffered hypovolemic shock, 33.9% also had primary PPH while 4 out of every 10 (39.8%) were transfused with blood. Seven out of every ten premature deliveries (prior to 34weeks gestation) were due to placental abruption with p value of <0.001. There were 2 maternal deaths (1%), 61 (31%) still births and 11 (5.6%) early neonatal deaths giving a perinatal mortality rate of 35.6%.Conclusions: Antepartum hemorrhage was associated with poor maternal and neonatal outcome in this study. There is need to improve on infrastructures, such as functional blood banks, appropriate antenatal care and referral system in our health facilities to be able to cope with increasing challenges of this obstetric hemorrhage.

Trends in the Epidemiology of Severe Pediatric Non-surgical Renal Disorders in Ibadan Nigeria: A Marked Increase in the Incidence of Acute Kidney Injury.

Background: Renal disorders are increasingly being recognized as major contributors to morbidity and mortality. Variability in their pattern in different populations and regions of the world and changes occurring with time have been demonstrated. We aimed to determine the current trends in the pattern of severe non-surgical childhood renal disorders at our Centre and compare the findings with previous studies. Methodology: A descriptive analytical study was carried out on consecutive incident cases of non-surgical renal disorders aged 14 years and below, managed in the Pediatric Nephrology Unit of the University College Hospital, Ibadan, Nigeria. Two separate time periods were studied. Results: A total of 869 incident cases of severe non-surgical disorders were admitted during the study periods. There was an increase in the hospital incidence from 1.5 to 2.2 per 100 pediatric admissions and in the average yearly admission from 43 to 103. The crude annual incidence increased from 42 per million age-related population (PMARP) to 86 (PMARP) at the end of the two study periods. The most remarkable increase occurred with Acute Kidney Injury, which showed a 6.5-fold rise and was the most common cause of renal morbidity and mortality in children encountered in the study. Interventional measures resulted in early detection, prompt treatment and reduced mortality. Conclusion: The study has shown an increase in the incidence of severe childhood renal disorders in Ibadan, with Acute Kidney Injury being the leading non-surgical renal disorder. A significant decline in case fatality rates was demonstrated in recent years.

Paediatric Renal Dialysis at the End of the 20th Century in Ibadan Nigeria.

Aim: To document the conditions requiring dialysis in children at the University College Hospital, Ibadan Nigeria, at the end of the 20th century, as well as the available dialytic modalities and short-term outcomes of dialysis for future comparisons. Patients and Methods: The data of all children aged 15 years and below who underwent peritoneal dialysis or haemodialysis in the Dialysis Unit between January 1990 and December 1999 were reviewed. A descriptive analysis of patients’ demography, aetiology of kidney failure, dialytic modalities and short-term outcome in these patients was performed. The primary outcome measure was mortality. Results: Sixty-six children comprising 14 (21%) boys and 52 (79%) girls underwent dialysis. The mean age was 11.9 (SD 3.9) years. Fifty-eight (88%) underwent peritoneal dialysis and 8 (12%) haemodialysis. A definitive diagnosis of Stage 5 chronic kidney Disease was made in 25 (38%), acute kidney injury in 23(35%) and acute kidney injury-on-chronic kidney disease in 6 (8%).The major underlying conditions were the nephrotic syndrome, acute glomerulonephritis and chronic glomerulonephritis. Others were diethylene glycol poisoning, malignancies and sepsis. Only acute dialysis was offered because of limited resources. Overall 25 died, giving a mortality rate of 37.9% with 12 (48%) and 22 (88%) patients dying within 3 days and 2 weeks of presentation respectively. Thirteen of the 25 (52%) patients in Stage 5 CKD, and 9 (39.1%) of the 23 with AKI, died and the mortalities were related more to the aetiologies. Conclusion: Acute glomerulonephritis and Nephrotic syndrome were the major causes of AKI while chronic glomerulonephritis was the major identified cause of Stage 5 CKD. The available dialytic modalities were peritoneal dialysis and the then newly introduced haemodialysis. Patients had no insurance cover and paid out of pocket for treatment thereby limiting the duration of dialysis. The short-term outcome compared favourably with outcomes in centres with similar predicaments.

Knowledge and Attitude of Exclusive Breastfeeding among Hairdresser Apprentices in Ibadan, Nigeria.

Aims: This study explored the knowledge and attitude concerning Exclusive Breastfeeding (EBF) among young women who are apprenticed to learn hairdressing in Agbowo community, Ibadan, Nigeria. Study Design: The study was cross sectional in design. Place and Duration of Study: Study was carried out in Agbowo community in Ibadan-north local government area of Ibadan, south-western Nigeria between January 2012 and June 2012. Methodology: Through the hairdresser’s association in the study area, 164 apprentices were enumerated but only 116 met the criteria and consented to participate. Semi-structured intervieweradministered questionnaires were used to collect data on socio-demography, knowledge of EBF and attitudes towards breast feeding. Knowledge questions and attitude statements were scored and grouped as adequate or inadequate knowledge; positive or negative attitude. Association between knowledge and socio-demographic variables were explored by chi-square analysis. Results: Most apprentices were between 21-25yrs (49%), attained the senior secondary (SSS) level of education (55.2%) and majority were single (91.4%).While many (63.8%) of the respondents had inadequate knowledge of EBF, nearly all of them (96.4%) had positive attitude to breast feeding. Only 36.23% knew that infants should receive breast milk only, 68.1% would give water and 53.4%would give herbal teas in the first six months of life. Some misconceptions (e.g. colostrum is dirty) and negative attitudes (e.g. breast feeding inconvenient, embarrassing, sags breasts) existed. A significant association exist between age group of respondents (p=.001); level of education (p=.001) and knowledge of exclusive breast feeding. Conclusion: Relevant interventions about EBF should focus on young people especially those with low levels of education, who have gaps in EBF knowledge so that misconceptions and negative attitudes can be resolved.

Histopathological Patterns of Thyroid Neoplasms in Ibadan Nigeria: A Twenty Year Retrospective Study.

Background: The thyroid gland is an endocrine organ which has an important function in regulation of physiological functions of normal body metabolism. Thyroid neoplasms are usually presented with palpable solitary or multiple nodules. This retrospective study aimed at describing the histopathological patterns of various thyroid neoplasms at the Pathology Department, University College Hospital (UCH), Ibadan between 1987 and 2006. Methods: We reviewed 174 cases with thyroidectomy and diagnosed thyroid neoplasm. We evaluated heamatoxilin and eosin stained slides retrieved from the records of the department and the population based cancer registry and where necessary the paraffin blocks were recut and stained. The World Health Organization Histological Classification of Thyroid tumour (2004) was used in this study. Results: A total 74,202 biopsies were received in the department over the study period. 1,207 cases were thyroidectomy specimens constituting 1.6% of all biopsies in the study period. 174 cases (14.4%) were thyroid gland neoplasms 122 (70.1%) of which were females and 52 of which (29.9%) were males. The ratio of female to male is 2.3:1. Seventy six (43.7%) cases were benign and 98 (56.3%) cases were malignant. Follicular adenoma accounted for 89.5% of benign thyroid neoplasms which makes a peak in the 5th decade. Papillary carcinoma was the most common malignant thyroid neoplasm in this study with a peak in the 3rd decade. Conclusion: This study showed that thyroid neoplasms were showing female predominance. The most common benign neoplasm was follicular adenoma and the malignant neoplasm was papillary carcinoma.

Non-doctor consultations and self-medication practices in patients seen at a tertiary dental center in Ibadan.

Aim: The aim of this study was to determine the prevalence of self-medication practices among dental out patients presenting at a tertiary health care center in Ibadan, and to determine factors that are associated with these practices. Materials and Methods: All patients presenting over a 4-month period, who consented to participate in the study, had a semi-structured questionnaire, highlighting age, sex, income and educational qualification, history of past practice of self-medication, substances used and reasons for resorting to self-medication administered to them. Data obtained were analyzed with the SPSS 12.0.1 software. Frequency tables were generated and statistical relationship between the variables was analyzed using the Chi-square test. Statistical significance was set at P>0.05. Results: There were 108 (38.03%) males and 176 (61.97%) females. A total of 139 (48.9%) of the respondents claimed that they have been involved in self-medication. 54.7% of the people involved in self-medication were female, while 41.7% were male. There was a statistically significant difference in self-medication between males and females (P=0.001). 71.2% of the respondents had post-secondary education and only 28.8% had secondary education or less. Conclusion: Self-medication practices were quite high in this study, and these practices were also prevalent among the educated people. Drug control enforcement needs to be intensified and dental public health education needs to be given greater priority in the overall public health campaigns.

Significant Bacteriuria Among Asymptomatic Antenatal Clinic Attendees In Ibadan, Nigeria

Untreated asymptomatic bacteriuria can lead to urinary tract infection (UTI) in pregnancy with devastating maternal and neonatal effects such as prematurity and low birth weight, higher fetal mortality rates and significant maternal morbidity. We carried out a two year (April 2007 to March 2009) cross-sectional epidemiological study to determine the prevalence of significant bacteriuria among asymptomatic antenatal clinic attendees at two antenatal clinics (ANCs) in University College Hospital and Adeoyo Maternity Hospital, both in Ibadan, Nigeria.<br />All consenting ANC attendees without UTI were enrolled in the study. Urine specimens of 5 to 10 ml collected from each subject were examined microscopically for white blood cells, red blood cells and bacteria. The specimens were further cultured on MacConkey agar using a sterile bacteriological loop that delivered 0.002 ml of urine. Colony counts yielding bacterial growth of more than 10⁵/ml of pure isolates were considered significant.<br />Of the 473 subjects studied, 136 had significant bacteriuria, giving a prevalence rate of 28.8%. The highest age specific prevalence (47.8%) was found in the 25–29 year olds while only one (0.7%) was found in the teenage group. A large percentage (64.0%) of subjects with significant bacteriuria had tertiary education, compared with 4.4% who had no formal education but the association was not statistically significant (X² = 0.47, p = 0.79). The majority (75.8%) of subjects with significant bacteriuria had no previous history of abortion, while 20 (14.7%) had one previous abortion and only three (2.1%) admitted to three previous abortions (X² = 5.16, p = 0.16). The majority (69.8%) of those with significant bacteriuria presented at second trimester while 38 (28.0%) presented at third trimester (X² = 6.5, p = 37).<br />Only 22 (4.6%) of the studied subjects presented at first trimester, and 3 (13.7%) of these had significant bacteriuria.<br />The prevalence of asymptomatic bacteriuria is high among this study population. Hence we suggest that advocacy programs be initiated to urge pregnant women to access ANC services early in pregnancy.