Bitter kola and kola nut use and their effect on treatment outcome on People Living with HIV at a Military Hospital in Benue state Nigeria: Bitter kola (Garcinia) and Cola nut (Cola nitida among PLWHIV

Introduction Bitter Kola (Garcinia Kola) and kola nut, contains substances attributed to numerous effects on humans including anti-inflammatory, anti-allergic properties, anti-infective and caffeinism. This study explores Bitter kola and kola nut use and its impact on treatment outcome on People Living with HIV (PLWHIV). Methods: The study was conducted at a Military Hospital in Nigeria. An analytical cross-sectional study was done using questionnaire among 700 HIV-positive clients selected using simple random sampling. Data were collected by researcher and three trained assistants. Chi-square test and binary logistic regression were used for identifying associations and predictors, respectively. The level of significance was set at p < 0.05. Results: Findings show that 260 (63.6%) and 179 (25.6%) have ever and currently used Bitter kola/Kola nut, respectively. Also, 14 (7.8%) used Bitter kola/Kola nut alone while 165 (92.2%) used it in addition to other substances, especially with alcohol 123 (68.7%). Bitter kola use was associated with age (p = 0.037), gender (p < 0.001), occupation (p = 0.001), and number of children (p < 0.011). Identified predictors were being a female (AOR 0.79; 95% CI 0.08-0.92) and earning <18,000 Naira (AOR 2.91; 95% CI 2.03-21.54). There was no association of Bitter kola/kola nut use with CD4 count and viral load suppression. Conclusion: Though Kola nut and Bitter kola use was high as in the general population we have not found any effect on treatment outcome among PLWHIV. This calls for more research to ascertain if there are other possible beneficial effects on PLWHIV.

Accessing Barriers and Determinants of Prevention of Mother to Child Transmission (PMTCT) of Human Immune Deficiency Virus (HIV) Services at Public Teaching Hospitals in Enugu State, Nigeria

Introduction:The most effective means of reducing Mother-to-Child transmission of HIV is to provide suppressive HAART. Prevention of Mother to Child Transmission (PMTCT) directly affects the achievement of Sustainable Development goals just. The unmet need for PMTCT services in Nigeria, particularly in Enugu state, is unacceptably high. This study aimed to assess factors associated with access barriers and determinants to PMTCT services in public health facilities in Enugu, Nigeria.Materials and Methods:The study design was a facility-based analytical cross-sectional study. HIV positive nursing mothers who were accessing PMTCT services were studied. Questionnaire was used. Chi-square test and Binary logistic regression was done to for determinants oexperience of any access barrier. Level of significance was determined at a p-value of ≤ 0.05.Results:A total of 2275 participants were reported on. A higher proportion of participants were in 30-34 years age group 124 (45.1%), attained secondary education 144(52.4%) and provided for by their husbands 174(63.3%) The major barriers identified were; long waiting time at the facility 184(66.9%), distance of facility 161(58.5%), PMTCT being far away from other units/departments 155(56.4%), Health workers talking to the clients with no respect 151(54.9%), Stigma and discrimination from friends/neighbours 163(59.3%) and from health workers 123(44.7%) as well as being too busy with householdchores 130(47.3%). There were statistically significant association between experience of barriers with age in categories (χ2=11.741, p =0.008), religion (χ2=5.381, p =0.020), source of income (χ2= 8.817, p=0.032) and ethnicity (χ2=9.240, p=0.026). Conclusion:Over ninety percent of respondents experienced a form of barrier. The major barriers include; long waiting time, distance to facility, location of PMTCT units, Health workers attitude, Stigma and discrimination from health workers as well as being too busy with household chores. There was no identified predictor of access barrier.

Emotional and Social Disorders among Overweight and Obese Children in Enugu, Nigeria: An Evolving Menace.

Background: Obesity results mainly from changes in diet and physical activity and currently being regarded as a global epidemic. It comes at a cost, affecting physical, social and psychological health and having deleterious impact on psychological development, academic and social performance of an affected child. The aim is to determine the burden of psychosocial disorders among the overweight and obese children in our environment. Methods: A descriptive cross sectional study carried out among secondary school children aged 10-18 years in Enugu metropolis. Sampling involved stratified and multi-staged methods. The height and weight of selected subjects were measured and their BMI calculated. An adapted, semi-structured, self-administered questionnaire was used. Information sought included socio-demographics and psychometric measurements. Data was analyzed using SPSS version 19. Analytical test of significance was done using Chi square test at p value of ≤ 0.05. Results: Of 200 students studied, 136 (68%) were females and 64 (32%) were males. Most (157) were in the age range of 10-14 years old. Sixty seven were overweight while 133 were obese with most of the children’s parents belonging to the upper socioeconomic class. One hundred and nineteen of them had one emotional and/or social problem of depression, anxiety, low self-esteem, discrimination and stigma, giving a prevalence rate of 59.5%. Thirty five (54.7%) males and 81 (61.8%) females had at least one emotional and/or social problem (χ2 = 0.905, p = 0.342). Between the children aged 10-14 and 15-18 years, 56.1% and 72.1% respectively experienced at least one psychosocial disorder (χ2 = 3.605, p = 0.058). Emotional and social disorders was commoner among the upper class and difference was statistically significant (χ2 = 6.375, p = 0.041). Conclusion: The burden of emotional disorders among overweight and obese children in Enugu metropolis is high. Socioeconomic class is associated with emotional disorders.

Factors that Influence Infant Feeding Options of HIV-Positive Mothers in Urban and Rural Communities in South-East, Nigeria.

Introduction: Infant feeding method decision making is a very vital aspect of child care. This study compares the factors influencing infant feeding options of HIV-positive mothers in urban and rural communities in southeastern Nigeria. Methods: It was a comparative cross-sectional study involving HIV-positive mothers whose babies were HIV-negative, and below 24 months using systematic sampling method. Questionnaires and Focused Group Discussion (FGD) guide were used. Results: About 123(54.7%) urban and 142(64.1%) rural dwellers intended exclusively breastfeeding (p = 0.150), however 88(39.1%) urban and 122(54.2%) rural dwellers actually exclusively breastfed (p = 0.001). The commonest reason for breastfeeding was belief that breast feeding was best for their babies (p = 0.003) while for formula feeding was that it protects the baby from HIV infection (p = 0.044). Family income with occupation for rural communities (p = 0.01, and p = 0.03 respectively) and family income for urban (p = 0.01) were significantly associated with infant feeding options. The FGD identified that disclosure of their HIV status to their husbands or relations helped the mothers in both communities maintain their feeding options. Conclusions: Infant feeding practices differed significantly between communities. Family incomes and occupation were factors influencing feeding options.

Disease Surveillance and Notification, Knowledge and Practice among Private and Public Primary Health Care Workers in Enugu State, Nigeria: A Comparative Study.

Aims: The study was to compare knowledge, practice of Disease Surveillance and notification as well as ascertain factors that influence it among Health care workers in public and private health centres in Enugu state, Nigeria. Study Design: Comparative cross sectional study. Place and Duration of Study: Selected public and private health facilities in Enugu state, Nigeria, between January and March 2013. Methodology: Health Care workers in selected public and private health facilities in southeast Nigeria eligible for voluntary participation were selected and studied. The participants were interviewed using a pretested, interviewer administered, semi-structured questionnaire. Data was analyzed using Statistical Packages for Social Sciences (SPSS) version 18 and level of significance was at p ≤ 0.05. Results: It was based on 160 HCWs (80 each from public and private). The mean age of HCWs was 41.21±8.54 and 38.68±14.64 for public and private respectively. Females > Males in both groups. Some of the factors associated with type of facility included; correct definition of IDSR (AOR= 2.6, 95% CI: 1.4–5.1), correct knowledge of diseases reported (AOR= 4.1, 95% CI 2.1-8.0), correct place to report to (AOR= 3.7, 95% CI 1.9–7.2), correct form for monthly reporting (AOR= 7.0, 95% CI 3.5–14.0), ever reported occurrence of disease (AOR= 8.5, 95% CI 4.0–18.2), reporting in correct place (AOR= 11.5, 95% CI 1.8–73.6), current availability of forms at facility (AOR= 4.9, 95% CI 2.5–9.5), supervision or data collection visits (AOR= 8.8, 95% CI 4.3–18.1) and regularity of the visits (AOR= 6.4, 95% CI 2.3–17.6). Conclusion: Disease Surveillance and Notification needs to be improved on especially in areas of manpower training and regular supply of forms for efficient Health Management Information System and containment of most diseases ravaging the nation.

Correlation between Anthropometric Variables, Social Class, Age and Hematological Profile among Children with Sickle Cell Anemia in ENUGU South-East Nigeria.

Background: Sickle cell anaemia (SCA), a common haematological genetic disorder, could affect both the growth and haematological profile of the sufferer. Objectives: This study aims at determining any correlation between anthropometric variables and haematological parameters among children with sickle cell anaemia (SCA). It also determines the association between social class and haematological parameters of children with SCA. Methods: A total of 80 subjects were recruited into the study, comprising 40 HbSS patients. This is cross sectional study of haematological indices and anthropometric measurement of children with sickle cell anaemia aged 6-20 years. All data were coded, entered, and then analyzed using the Statistical Package for Social Sciences program (SPSS), version 20. Results: There was statistical significant correlation between BSA and total white blood cell count (TWBC) (p=0.028) but not with Haemoglobin concentration (Hb) and Erythrocyte sedimentation rate (ESR). Hb: r=0.073, p=0.654 ESR: r=0.224, p=0.164 TWBC: r=0.348, p=0.028. The Haemoglobin concentration, TWBC and ESR values are 7.77 g/dl, 11.96×109, and 15.4 mm/hr There is also no statistical significant correlation between BMI and haematological variables: TWBC r= 0.100 p=0.51, Hb: r=0.118, p= 0.469 ESR: r= 0.033, p=0.841. There is also no statistical significant correlation between chest circumference and haematological indices. TWBC r= 0.216 p=0.181, Hb: r=0.043, p= 0.793 ESR: r= 0.143, p=0.378. There were no statistical differences in mean for all the variables studied among the social classes. Hb; p=0.373 ESR p=0.633. TWBC p= 0.451. Conclusion: Infection is not the only cause of elevation in TWBCs. it is important to also consider the impact of surface area on white blood cell count of children with SCD before using antimicrobials for such infections.

Child sexual abuse among adolescents in southeast Nigeria: a concealed public health behavioral issue

Child sexual abuse among adolescents is an often overlooked issue in pediatrics, yet it is a major cause of low self esteem and stigmatization in adolescents. The objective of this study was to determine the socioeconomic determinant and pattern of child sexual abuse among adolescent attending secondary schools in South East Nigeria. This was a cross-sectional study that was carried out among children in three secondary schools in Enugu and Ebonyi states of Nigeria. Five hundred and six adolescents who met inclusion criteria were consecutively recruited into our prospective study between June and October, 2014. One hundred and ninety nine [40%] of the respondents had been abused and the commonest form of abuse was to look at pornographic pictures, drawings, films, videotapes or magazine 93[18.4%]. Fifty eight [11.5%] adolescents stated that they were abused once with age at first exposure being 7-12 years 57 [11.4%]. When grouped together, family members and relatives are perpetrators of child sexual abuse. There was significant difference in sex abuse between males and females [p=0.014] while there were no significant difference for age [p=0.157] and social class [p=0.233]. Overall prevalence and one time prevalence rates of sexual abuse among adolescents in south east Nigeria was 40% and 11.5% respectively with male perpetrators. There is no link between socioeconomic class, age and child sexual abuse among adolescents