Descriptive epidemiology of measles surveillance data, Osun state, Nigeria, 2016-2018.

BACKGROUND: Globally, an estimate of 254,928 measles cases in 2015 and 89,780 deaths in 2016 occur annually. In Nigeria, measles is the fifth leading causes of under-five child mortality with 342 confirmed cases found in the first 9 epidemic weeks in some states including Osun State. We described the distribution, trend and make projection of measles cases in Osun State. METHODS: The Osun State surveillance weekly reporting data on measles cases from all its 30 Local Government Area (LGA) were reviewed, from January 2016 to December 2018 (n = 1205). Data were analyzed using descriptive statistics and a multiplicative time series model (MTSM). The MTSM was used to determine the trend, seasonality in the data and make projections for 2019 and 2020. RESULTS: Cases of measles were reported across the 30 LGAs of the state between January 2016 and December 2018. The rate of reported cases of measles was 20.2, 34.4 and 28.8 per 100,000 populations in 2016, 2017 and 2018 respectively in Ede south LGA where the highest rates were reported in the 3-year period. Out of the three studied years, year 2017, recorded the highest number of reported cases of measles in Osun State. The trend line for the 3-year period showed a positive correlation (r = + 0.4979, p = 0.056). The computed quarterly variation for the studied years was 1.094 for the 1st quarter, 1.162 for the 2nd quarter, 0.861 for the 3rd quarter and 0.888 for the 4th quarter. A quarterly projection for 2019 and 2020 showed an increasing trend with the second quarter of each year likely to have the highest reported cases of measles. CONCLUSIONS: Ede south LGA has the highest proportion of reported measles cases in Osun State. Measles cases may increase in years ahead, but the second quarter of a year has the highest number. Government should strengthen the existing framework on measles reduction and more attention should be given to the second quarter of each year.

Differential effect of wealth quintile on modern contraceptive use and fertility: evidence from Malawian women.

BACKGROUND: High fertility and wide inequality in wealth distribution are phenomenal problems in sub-Saharan Africa. Modern Contraceptives (MC) are useful for limiting fertility, but are not always easily accessible in Malawi. This study examines the gap in MC use and fertility between women in the richest and poorest Wealth Quintile (WQ). METHODS: The study was cross-sectional in design and utilized Malawi DHS dataset, 2010. It focused on women of reproductive age. The dependent variables are ever and current use of MC. Chi-square and multinomial logistic regression were used for the analysis. RESULTS: Mean children ever born by women in the poorest and richest WQs were 3.94 ± 2.7 and 2.82 ± 2.3 respectively (p < 0.001). The adjusted total fertility rate (Adj.TFR) was higher among women in the poorest (Adj.TFR = 7.60) WQ than the richest (Adj.TFR = 4.45). The prevalence of ever use of MC was higher among women in the richest WQ (82.4%) than the poorest (66.8%) (p < 0.001). Similar pattern exists for current use of MC; 58.5% and 45.9% for women in the richest and poorest WQs respectively (p < 0.001). Women in the richest WQ were more likely to ever use (OR = 2.36; C.I = 2.07-2.69, p < 0.001) and currently using (OR = 1.66; C.I = 1.40-1.97, p < 0.001) MC than their counterparts in the poorest WQ. Slight reduction in odd-ratio of MC use among women in richest WQ resulted when socio-demographic variables were used as control. CONCLUSION: Fertility was higher and the use of MC was lower among women in the poorest than their counterparts in the richest WQ. Ensuring availability of MC at little or no cost may bridge the gap in contraceptive use between women in the poorest and richest WQ in Malawi.

Determinants of unmet need for modern contraception andreasons for non-use among married women in rural areas of Burkina Faso

Burkina-Faso (TFR=6.0) is among the top-ten high fertility countries world-wide and CPR (15) among women is low. This study examined the factors associated with non-use of modern contraception among married women residing in the rural areas of Burkina-Faso. The study used 2010 Burkina Faso Demographic and Health Survey data-set and focussed on married women aged 15-49 years (n=7;191). Chi-square and logistic regression techniques were used for the analysis (a=5). Mean number of living children was significantly higher among women who have UNMC (3.92) than those with met need (3.01). Modern CPR and UNMC among married women was 12.7 and 40.7 respectively. The multivariate analysis reveals that being married more than once increases the likelihood of UNMC (OR=1.304; C.I=1.0821.571; p0.05). Husbands' approval of FP is a protective factor of UNMC (OR

Patterns and correlates of condom use among unmarried male youths in Nigeria: NDHS 2008.

The HIV/STDs constitute public health problem. Condom use during sexual intercourse has been proved to be a good means of protection against HIV/STDs. Unmarried male youths which constitute a high proportion of Nigerians will be at risk of HIV/STDs if they fail to use condom. Reducing HIV/STDs in Nigeria will be difficult if research on condom use among youths is neglected. This retrospective cross-sectional design study utilized 2008 NDHS dataset. It focused on unmarried male youths aged 15-24 (n=1575) who ever had sexual intercourse (vaginal, oral and anal). The dependent variables were ever used and current use of condom. Data was analyzed using Chi-square and logistic regression (alpha=5.0%). Mean age of the respondent was 20.5 +/- 2.4, 62.0% ever used condom and 49.5% currently using condom. Among the sexually active; age, region, residence, education, wealth index, ever undergone HIV test and total life-time number of sexual partners were significantly associated with current use of condom. Living in the southern regions of Nigeria promotes the use of condom. The odds of ever use of condom was higher among male youths who were in the middle (OR=2.36; C.I=1.48-3.78), richer (OR=2.93; C.I=1.81-4.72) and richest (OR=3.52; C.I=2.07-6.00) wealth quintiles than the poorest. Ever undergone HIV test increased the likelihood of using condom. Condom use among unmarried male youths in Nigeria is low. Distribution of condom at no cost and undergoing HIV test will increase utilization of condom among unmarried male youths in Nigeria.

Survival analysis of timing of first marriage among women of reproductive age in Nigeria: regional differences.

Early marriage is common among women in developing countries. Age at first marriage (AFM) has health implication on women and their under-five children. In Nigeria, few studies have explored AFM; the current study was designed to fill the gap. Nigeria Demographic and Health Survey, 2008 dataset on married women aged 15-49 (N = 24,986) was used. Chi-square, OLS regression and Cox proportional hazard models were used in the analysis. The mean AFM was 17.8 +/- 4.8 years and significant difference existed between the mean AFM of women in the North (16.0 +/- 3.6) and South (20.4 +/- 5.0) (p < 0.001). Region, education, religion, residence, nutritional status, age at first sexual intercourse and children ever born were significantly associated with timing of first marriage (p < 0.001). Majority of the women married between ages 15-19 years (43.1%), while very few married late (2.3%) and about 27.0% married too early (less than 15 years). Early marriage was more common in all the regions in the North than the South and the hazard was highest in the North West and North East. Women who reside in rural area (H.R = 1.15; C.I = 1.11-1.18) married early than their counterparts in the urban area. Age at first marriage was directly related to levels of education (p < 0.001). Muslim women married early (H.R = 1.34; C.I = 1.29-1.39) than Christians. Three models were generated from the data. Women married too early in Nigeria with Teenage marriage more common in the North than the South. Education has influence on AFM; therefore, women should have at least secondary education before marriage in Nigeria.

Contraceptive use: implication for completed fertility, parity progression and maternal nutritional status in Nigeria.

The study identified socio-demographic factors influencing contraceptive use while using nutritional status, completed fertility and parity progression as key variables. NDHS, 2008 dataset on married women aged 45-49 was used. Chi-square, ordinary linear and logistic regression models were used for the analysis. The mean age of the women and CEB were 46.8 +/- 1.5 years and 6.9 +/- 3.1 respectively. About 26.0% of the women ever used contraception, while 9.0% of the women were underweight. Parity progression from parity 0 to 4 was consistently higher among never-users than women who ever used contraception. The tempo changes for all parities above four as ever-users now progress at lower rate during these periods. The completed fertility and the risk of undernourishment were significantly higher among never users of contraception than ever users. The level of risk persists even when the potential confounding variables were used as control.