Perception of risk of HIV and sexual risk behaviours among students in the United States; Turkey and South Africa

The aim of this study was to examine HIV sexual risk behaviours and perception of HIV risk among 1 095 students from the United States of America (US); Turkey and South Africa. Randomly selected students who were enrolled in general education courses completed a structured questionnaire. Results revealed statistically significant differences in specific HIV-related sexual behaviours among students from the three countries and among male and female students in each country. A higher percentage of US and South African students engage in HIV risky sexual behaviours compared with their Turkish counterparts; and a higher percentage of female students in the US and South Africa engage in HIV sexual risk behaviours compared with their male colleagues. A higher proportion of Turkish male students engaged in sexual risk behaviours compared with their female counterparts. The perception of HIV risk was low among US and Turkish students; and high among South African students. There was no agreement between engaging in risky sexual behaviour and self-perception of HIV risk among South African female students; while agreement was poor for US male and female students; Turkish male and female students; and South African male students. The observed optimistic bias needs to be considered in the design and implementation of HIV prevention programmes for these populations

Plasma glucose level in Nigerian Africans with head injury.

Trauma is often associated with increased plasma glucose concentrations. This prospective study was designed to determine random plasma glucose concentrations in patients with head injury in our center and to determine if this is related to injury severity and outcome. Patients with head injury in whom the plasma glucose concentration could be determined at our accident and emergency unit during the study period were included. We obtained information on demographic data, diagnosis, injury severity using Glasgow Coma Scale scores, treatment with glucose-containing fluid prior to presentation in our center, plasma glucose on admission, 24 hours later and 72 hours later and outcome at discharge using the Glasgow Outcome Scale score. Hyperglycemia was defined as glucose concentrations above 11.1 mmol/L. Fifty eight patients were included in the study from October 2004 to December 2005. There were 46 males and 12 females (4:1). The mean age (+/- standard deviation [SD]) was 31.3 (16.4) years. Fourteen patients (24.1%) had mild head injury, 21 patients (36.2%) had moderate head injury and 23 patients (39.7%) had severe head injury. The outcome was good in 29 patients (50%), moderate disability in five patients (8.6%), severe disability in one (1.7%) and death in 10 (17.2%). Eighty percent of the patients who died had severe head injury. Most of the patients had a plasma glucose in the normal range irrespective of the severity of the head injury. Only one patient had a plasma glucose in the hyperglycemic range and that patient had a severe head injury. Fifty percent of the patients who died had a plasma glucose concentration in the normal range; none in the hyperglycemic range. This study shows that the plasma glucose is generally below hyperglycemic concentration in our patients irrespective of the severity of head injury.

Evaluation of the content validity, internal consistency and stability of an instrument designed to assess the HIV/AIDS knowledge of university students.

OBJECTIVE: This study evaluated the content validity, internal consistency and stability of a questionnaire designed to assess the HIV/AIDS knowledge of young adults. METHODS: The questionnaire was administered on two occasions, within two week intervals, to 219 university students in the USA (n=66), Turkey (n=53) and South Africa (n=100). The psychometric instrument contained demographic information questions and 45 knowledge questions regarding the HIV virus, ways of transmitting it, symptoms of HIV/AIDS infection and methods of prevention. Factor analysis was conducted to assess construct validity; Cronbach alphas and Pearson's product moment correlation (r) were calculated to evaluate internal consistency and stability, respectively. RESULTS: The 45 knowledge questions produced a Kaiser-Meyer-Olkin (measure of sampling adequacy) value of 0.8133 and loaded on three factors with an overall Cronbach's alpha of 0.861. The r for the individual knowledge question was greater than 0.50 and the overall knowledge score was "almost perfect" (0.91; p<.001). For participating students from the USA, Turkey and South Africa, their r for the overall knowledge score was 0.80 (p<.001), 0.83 (p<.001) and 0.93 (p<.001), respectively. CONCLUSIONS: Our findings revealed that the instrument is highly stable and internally consistent. The availability of this instrument may enhance HIV intervention studies internationally.

Impact of nutritional education on nutritional status of under-five children in two rural communities of south-west Nigeria.

OBJECTIVES: This study evaluated the impact of nutritional education on knowledge, attitude and practices (KAP) of mothers concerning infants and young children feeding and their children's nutritional status in two semi-urban communities of south-west Nigeria. MATERIALS AND METHODS: This is a community intervention study. We recruited 150 mothers of children aged 0-18 months independently from the intervention and control communities through a multi-stage sampling technique. We collected data with the aid of an interviewer-administered questionnaire at baseline and at six months after intervention from both communities to obtain information on feeding of infants and young children. In addition, we measured weights and heights of recruited children. Intervention involved group counselling of mothers and food demonstrations at designated health facilities. Data analysis for quantitative data was done using Epi-Info software, and for qualitative data, content analysis of major themes was used. RESULTS: Before intervention, recruited mothers and their children from the two communities were comparable in terms of all the parameters assessed (P>0.05 in all cases). After six months of intervention, mothers who had nutritional education demonstrated better knowledge and attitudes to key infant and young children feeding recommendations. There was also limited improvement in feeding practices. Mothers from the intervention community exclusively breastfed their infants longer with mean age at introduction of complementary foods at 5.3 months compared to 4.5 months in the control community (P<0.05), breastfed their children longer (P<0.05). However, there was no statistically significant improvement in the weight of their children. CONCLUSION: In this study, nutritional education of mothers only had positive impact on their level of KAP on infant and young children feeding.

Soil-transmitted helminth infections in Nigerian children aged 0-25 months.

The objective of this cross-sectional study was to determine the prevalence and intensity of soil-transmitted helminths (STHs) in children aged 0-25 months and to identify the associated risk factors for Ascaris lumbricoides infections. The study was conducted in three villages outside Ile-Ife, Osun state, Nigeria in May/June 2005. Stool samples (369) were processed by formol-ether concentration. Ascaris lumbricoides (12.2%) was the dominant infection. Age, father's occupation and dog ownership were identified as the significant risk factors in the minimal adequate model for A. lumbricoides. The odds of being infected with A. lumbricoides increased as the children got older. Children aged 12-17 months and 18-25 months were 8.8 and 12.4 times, respectively, more likely to harbour Ascaris than those aged 7-11 months. The odds of harbouring Ascaris for children whose families owned a dog were 3.5 times that of children whose families did not own a dog. Children whose fathers were businessmen were 0.4 times less likely to be infected with Ascaris than those whose fathers were farmers. The findings from this study suggest that many of these young children, who are at a critical stage of development, are infected with Ascaris and that the prevalence of infection with this parasite increases with age. This study has highlighted the need to incorporate preschool children into deworming programmes in endemic regions and to investigate innovative ways of delivering cost-effective deworming treatment to this high-risk age group.

Pre-incarceration HIV risk behaviours of male and female inmates.

In most countries, HIV and AIDS rates are higher among inmates than in the general population. As part of a series of studies aimed at examining the plausible links between HIV and incarceration in a State prison system in the United States (US), the present study examined pre-incarceration sexual and injection drug use behaviours of inmates and their demographic correlates. Two-hundred-andsixteen female and 260 male inmates randomly selected from 17 Illinois State prisons completed a structured questionnaire. Findings indicate that the rate of inconsistent condom use with multiple anal and vaginal sexual partners among study participants ranged from 11 to 49%. Fourteen per cent of the women and 25% of the men reported ever injecting drugs, while 13% of the women and 7% of the men had ever shared needles. Demographic correlates of risk behaviours differed between gender and for specific behaviours. The findings indicate that persons entering prison generally exhibit risk behaviours that may increase their chances of acquiring HIV. Comprehensive HIV prevention programmes should be made available to inmates in US prisons and be accessible to them upon release. Studies are needed to examine how individual and structural factors interact to increase HIV and incarceration risk.

Determinants of consistent condom use among adolescents and young adults attending a tertiary educational institution in Ile-Ife, Nigeria.

OBJECTIVES: This study evaluated the determinants of consistent condom use among adolescents and young adults aged 15 - 29 years. METHODS: This was a cross-sectional survey to which 600 (300 of each gender) adolescents/young adults who had never married were recruited. Information was collected from respondents by means of a purpose-designed, self-administered questionnaire. Information sought includes the respondents' social and demographic characteristics, sexual practices and issues relating to condom use. RESULTS: Five hundred and thirty-six (89.3%) of the 600 questionnaires were suitable for analysis; 372 (69.4%) had had sexual intercourse. A third reported that they were having sex frequently or fairly frequently; 145 (41.7%) had more than one partner while 74 (19.9%) were aware that their partners had other sexual partners. Two-thirds of currently sexually active respondents reported that condoms were readily available and cheap although only 90 (24.2%) reported using condoms consistently. The factors that were statistically significant predictors of consistent condom use among the males were age; younger respondents were more likely to be consistent users (p = 0.015), having more than one sexual partner (p = 0.030) and ability to refuse sex with a partner who would not want to use condom (p = 0.008). Among the females, statistically significant predictors were frequency of sexual intercourse; respondent who had sex frequently were more likely to use condoms consistently (p = 0.018) and having more than one partner (p=0.018). CONCLUSION: Inconsistent condom use is rampant and females were probably disadvantaged as far as condom negotiation is concerned.

Efficacy of intermittent preventive treatment of malaria with sulphadoxine-pyrimethamine in preventing anaemia in pregnancy among Nigerian women.

OBJECTIVE: To evaluate the efficacy of intermittent preventive treatment of malaria using sulphadoxine-pyrimethamine (SP) in the prevention of anaemia in women of low parity in a low socio-economic, malaria endemic setting. METHOD: The study design was an open randomized control trial comparing anaemia incidence among pregnant women on intermittent presumptive treatment of malaria with SP with those on chloroquine (CQ). A total of 352 primigravid and secondigravid women between 16 and 30 weeks gestation receiving antenatal care at the Primary Health Care Center, Enuwa in Ile-Ife, Osun State, Nigeria were serially recruited and randomly allocated into experimental and control groups of 176 each. The experimental group received SP (to a maximum of three doses depending on the gestational age at enrollment into the study) while the control group had treatment doses of CQ at recruitment and subsequently only if they had symptoms suggestive of malaria. The primary outcome measure was anaemia (haematocrit<30) at 34 weeks of gestation. RESULT: At recruitment and 34 weeks gestation, there was no statistically significant difference between the experimental and control group in terms of socio-demographic characteristics and past medical history. Thirty-three (22.6%) and 52 (37.1%) women in the study and control groups, respectively, had anaemia (protective efficacy 49.5%, p=0.01). With multivariate analysis, controlling for the possible confounding effects of education, parity, haemoglobin level at booking and malaria parasitaemia in peripheral blood, the difference in the incidence of anaemia in the two groups remained significant (p=0.01; odds ratio=0.5; 95% confidence interval=0.29-0.85). CONCLUSION: The IPT regime with sulphadoxine-pyrimethamine is an effective, practicable strategy to decrease risk of anaemia in women of low parity residing in areas endemic for malaria.

Pattern of alcohol consumption among commercial road transport workers in a semi-urban community in south western Nigeria.

OBJECTIVES: To determine prevalence and pattern of alcohol use, evaluate the level of awareness of the harmful consequences of drinking, and determine the relationship between alcohol use and some selected factors among commercial road transport workers. DESIGN: Cross-sectional survey. SETTING: All the five motor parks spread over Ile-Ife, a semi-urban community in south western Nigeria. RESULTS: out of the 403 transport workers, 400 (99.3%) agreed to participate in the study. The questionnaire of one respondent was rejected. The current prevalence rate of alcohol use was 67.2%. Forty seven percent were 'heavy' users; 15.3% 'moderate' users and 37.7% were occasional or 'mild' users. All the users were engaged in the use of commonly available alcoholic beverages in the vicinity of the motor parks. Majority of the respondents (74.5%) reported drinking after work; 13.5% in the mornings; 10.1% when off-duty and 1.9%, during work. Frustrations that are associated with their work topped the list of reasons adduced for drinking. Belonging to lower age groups was significantly associated with current drinking (chi2 = 17.46, df = 3, p < 0.001). The proportions of respondents with unsatisfactory level of awareness regarding the association of current drinking with road traffic accidents, and with physical complications were high. CONCLUSION: Current alcohol use and use in a hazardous manner is an important public health problem among commercial road transport workers in Nigeria. There is an urgent need to modify existing legislations or enact new laws on 'driving under the influence' of alcohol, and enforce them.

The first six month growth and illness of exclusively and non-exclusively breast-fed infants in Nigeria.

OBJECTIVE: To compare the growth and illness pattern of infants who were exclusively breast fed for six months with those of infants commenced on complementary feeding before the age of six months and ascertain reasons for the early introduction of complementary feeding. DESIGN: A comparative prospective study. SETTING: Urban Comprehensive Health Centre (UCHC), Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife. SUBJECTS: Three hundred and fifty-two mothers and their normal birth weight babies, weighing 2.500kg or more, and aged less than 14 days were serially recruited into the study. MAIN OUTCOME MEASURES: Mean/median monthly weights in the first six months of life, history/outpatient presentation for illnesses. RESULTS: Of the 352 mother-infant pairs recruited into the study, 345 (98%) were successfully followed up for the first six months of life. At six months, 264 (76.5%) were exclusively breast-fed, 45 (13.1%) were started on complementary feeding, between the ages of four and six months while 36 (10.4%) commenced complementary feeding before the age of four months. Infants who were exclusively breast-fed for six months had median weights above the 50th percentiles of the WHO/NCHS reference that is currently used in the national "road to health" (growth monitoring) cards. Furthermore, the mean weight of these babies at age six months was above those of babies who started complementary foods before six months. They also reported fewer symptoms and had fewer illness episodes (0.1 episodes per child) compared to those who started complementary feeding before six months. Infants who commenced complementary feeding before four months reported more symptoms and had more illness episodes (1.4 episodes per child) compared to those that commenced complementary feeding between four and six months (1.2 episodes per child). Common symptoms/illnesses seen or reported during the study among the groups were fever, diarrhoea and cough. Reasons given for early introduction of complementary foods include insufficient breast milk, thirst and convenience. CONCLUSION: It is concluded that exclusive breast-feeding supported adequate growth during the first six months of life for most of the infants studied. Early introduction of complementary foods did not provide any advantages in terms of weight gain in our environment, it was frequently associated with illness episodes and growth faltering. Many mothers however require support, encouragement and access to health care providers to breastfeed exclusively for the first six months of life.

Perceptions of occupational hazards amongst office workers at the Obafemi Awolowo University, Ile-Ife.

BACKGROUND: A Survey of 350 office workers at the Obafemi Awolowo University (OAU), Ile-Ife was conducted to determine respondents' perceptions of the occurrence of work-related hazards and to characterize the pattern of hazards found prevalent in the population. METHODS: The survey employed a descriptive cross-sectional design. Data were generated through the use of a structured self-administered questionnaire and a non-participant observation checklist. RESULTS: Between 39% and 47% of the respondents expressed dissatisfaction with the level of control of the factors of the work environment (heat, noise, illumination, space, ergonomics). Two-thirds of respondents presented with work-related low backache, and this was more so for respondents who had spent at least 10 years on the job than those who had spent less. Of the 227 keyboard operators interviewed, 130 (57%) experienced symptoms suggestive of the overuse syndrome and 70% of the 82 computer operators interviewed had experienced varying degrees of visual fatigue since their appointments. CONCLUSION: The study concluded that the present design and layout of offices/workstations and access to equipment at the Obafemi Awolowo University, Ile-Ife is not optimal and tend to promote unnecessary physical efforts. This, in turn, might reduce efficiency and productivity. Suggestions for improvement were made as a way forward.

Growth pattern of exclusively breast-fed infants during the first six months of life in Ile-Ife, Osun State, Nigeria.

Several studies to determine the growth pattern of exclusively breast fed infants have provided varying conclusions as to the sufficiency of breast milk alone to support adequate growth for the first six months of life. Disagreement exists concerning the optimal timing of introduction of complementary foods to exclusively breast fed infants. This prospective study thus examined the adequacy of breast milk alone to support normal growth during the first six months of life in our environment. The overall objective was to propose a scientifically sound national recommendation on the appropriate timing for the introduction of complementary feeding in Nigeria. Three hundred and fifty-two mother/infant pairs were serially recruited into the study; all babies were aged 14 days or less and weighed 2.5 kg and above. Three hundred and forty-five (98%) were successfully followed up till the infants were six months old. By six months, 264 (76.5%) were exclusively breast-fed, while 81 (23.5%) had commenced complementary feeding. Growth curves of exclusively breast-fed infants showed increasing weight from birth to six months. Although the 50th percentile birth weight for both boys and girls were the same (3.2 kg), boys gained weight faster than the girls from the age of one month to six months and were heavier at six months. Additionally, the 50th percentile curves of these infants (both genders) for the first six months were above the 50th percentile curve of the World Health Organisation and National Centre for Health Statistics (WHO/NCHS) reference currently used on our national "road to health" (growth monitoring) cards. It was concluded that exclusive breast-feeding supported adequate growth during the first six months of life for most of the children studied and that our national recommendation that infants be introduced to complementary feeding at six months is appropriate.