Preferences, Utilization and Factors affecting Use of Contraceptives among Women attending Primary Health Care Facilities in Delta State, Southern Nigeria.

BACKGROUND: Contraceptive use has numerous benefits for the family and the nation that can be maximized with its consistent use. However, many women have preferences for certain contraceptives with implications for continued use. OBJECTIVE: To determine the contraceptive preferences of women, their utilization pattern and factors affecting utilization of the preferred contraceptive choices. METHODS: This cross-sectional study was conducted among 426 women of reproductive age selected from 32 primary health facilities using multistage sampling technique. Data was collected using a semi-structured interviewer-administered questionnaire. Descriptive and inferential analysis of data collected was carried out using IBM SPSS version 22 software. P-value was set at 0.05. RESULTS: Close to half of the respondents 211 (49.5%) preferred injectable contraceptives, 79 (18.6%) selected implants and 27 (6.3%) chose condoms. The majority 212 (49.8%) of respondents used injectable contraceptives, followed by implants 66 (15.5%), condoms 33 (7.7%), IUCD 54 (12.7%) and OCP 61 (14.3%). Age (p<0.001), number of children (p<0.001), clients' employment status (p<0.001), husband support (p<0.021) and desire for more children (p<0.001) were all statistically associated with the utilization of preferred contraceptives. CONCLUSION: Even though respondents preferred the injectable contraceptives, implants and IUCD in that order, their utilization pattern followed the order of Injectable, implants and OCP. Several factors were identified to be statistically associated with the utilization of preferred contraceptives. Health education on contraceptive use among women, spousal support and health workers training to highlight those factors influencing women's contraceptive preferences and utilization are recommended.

CONTEXTE: L'utilisation de la contraception présente de nombreux avantages pour la famille et la nation qui peuvent être maximisés par son utilisation régulière. Cependant, de nombreuses femmes ont des préférences pour certains contraceptifs, ce qui a des conséquences sur leur utilisation continue. OBJECTIF: Déterminer les préférences des femmes en matière de contraception, leurs habitudes d'utilisation et les facteurs qui influent sur l'utilisation des choix contraceptifs préférés. MÉTHODES: Cette étude transversale a été menée auprès de 426 femmes en âge de procréer, sélectionnées dans 32 établissements de santé primaire en utilisant une technique d'échantillonnage à plusieurs degrés. Les données ont été recueillies à l'aide d'un questionnaire semi-structuré administré par un enquêteur. L'analyse descriptive et inférentielle des données recueillies a été réalisée à l'aide du logiciel IBM SPSS version 22. La valeur P a été fixée à 0,05. RÉSULTATS: Près de la moitié des répondants 211 (49,5%) ont préféré les contraceptifs injectables, 79 (18,6%) ont choisi les implants et 27 (6,3%) les préservatifs. La majorité 212 (49,8%) des répondants ont utilisé des contraceptifs injectables, suivis par les implants 66 (15,5%), les préservatifs 33 (7,7%), les UICD 54 (12,7%) et les COC 61 (14,3%). L'âge (p<0,001), le nombre d'enfants (p<0,001), la situation professionnelle des clientes (p<0,001), les croyances religieuses (p<0,053), le soutien du mari (p<0,021) et le désir d'avoir plus d'enfants (p<0,001) étaient tous statistiquement associés à l'utilisation des contraceptifs préférés. CONCLUSION: Bien que les répondants aient préféré les contraceptifs injectables, les implants et les DIU dans cet ordre, leur utilisation a suivi l'ordre suivant : injectables, implants et COC. Plusieurs facteurs ont été identifiés comme étant statistiquement associés à l'utilisation des contraceptifs préférés. Il est recommandé de mettre en place une éducation sanitaire sur l'utilisation des contraceptifs par les femmes, de soutenir les conjoints et de former les agents de santé afin de mettre en évidence les facteurs qui influencent les préférences et l'utilisation des contraceptifs par les femmes. Mots clés: Contraceptifs, Planning familial, Préférence, Utilisation.

A Method of Conservative Management of Giant Omphalocele Useful in Preventing Rupture of Sac.

BACKGROUND: Omphalocele consists of congenital malformation of anterior abdominal wall defects occurring at the midline with herniation of the viscera through this defect. Giant omphaloceles constitute a challenging situation as such conservative management has been advocated as an effective method of treatment. This study aimed to compare the conventional method of dressing the omphalocele sac using gauze, an escharotic agent, and a crepe bandage to our improvised method of the usage of a sterilization wrap over the escharotic agent with a crepe bandage. METHODS: This was a retrospective comparative review of 7 babies with giant omphalocele that was treated with topical honey and the non-adherent sterilization wrap covering (group B) and compared with 6 babies that had honey, sofratulle ,and dry gauze covering (group A) that was initially done in our center. RESULTS: All of the babies who were in group B had an uneventful epithelization of the sac with no rupture; also, no death occurred in this group. However, three in group A had sacs that ruptured before epithelization. Two of these died from complications of sepsis following rupture of the sac, one had a small point on the sac which was ruptured and it healed with a dressing left in place for a week. CONCLUSION: The use of Kimberley-Clark sterilization wrap prevents rupture of the sac while using the escharotic agent, thereby reducing mortality. We advocate that gauze should not make any contact with the omphalocele sac.

CONTEXTE: Omphalocele consiste en une malformation congénitale deanomalies de la paroi abdominale antérieure survenant à la ligne médiane avechernie des viscères à travers ce défaut. Omphalocèles géantsconstituent une situation difficile en tant que telle gestion conservatricea été préconisé comme une méthode de traitement efficace. Cette étudevisant à comparer la méthode conventionnelle d'habillage dusac omphalocèle utilisant de la gaze, un agent escharotique et un pansement en crêpeà notre méthode improvisée d'utilisation d'une enveloppe de stérilisation sur leagent escharotique avec un pansement en crêpe. MÉTHODES: Il s'agissait d'une revue comparative rétrospective de 7 bébés atteints deomphalocèle géant qui a été traité avec du miel topique et le revêtement d'enveloppement de stérilisation non adhérent (groupe B) et comparé à 6bébés qui avaient du miel, de la sofratulle et de la gaze sèche couvrant (groupe A)cela a d'abord été fait dans notre centre. RÉSULTATS: Tous les bébés qui étaient dans le groupe B ont eu une situation sans incident.épithélisation du sac sans rupture; de plus, aucun décès n'est survenu dans cegroupe. Cependant, trois dans le groupe A avaient des sacs qui se sont rompus avantépithélisation. Deux d'entre eux sont morts de complications de la septicémiesuite à la rupture du sac, on avait une petite pointe sur le sac quia été rompu et il a guéri avec un pansement laissé en place pendant une semaine. CONCLUSION: L'utilisation de l'emballage de stérilisation Kimberley-Clark prévientrupture du sac lors de l'utilisation de l'agent escharotique, réduisant ainsimortalité. Nous préconisons que la gaze ne devrait pas entrer en contact avecle sac omphalocèle. MOTS-CLÉS: Omphalocèle géant, Enveloppe de stérilisation Kimberly.

The Prevalence and Outcome of Teenage Pregnancies in a Secondary Health Facility in Delta State, Nigeria: A Four-Year Retrospective Review.

INTRODUCTION: This study determined the prevalence, obstetric characteristics and pregnancy outcomes in teenagers who delivered at a secondary health facility in a Southern State in Nigeria. MATERIALS AND METHODS: A retrospective study was employed to review pregnancies that were managed in Central Hospital Warri, Delta State, Nigeria between 2014-2017. Patients' notes were retrieved and analyzed with respect to the socio-demographic characteristics, pregnancy, labor and delivery complications and fetal outcome. Chi-square test was used to test the association between the independent variables and the main outcomes of the study with statistical significance set at p<0.05. RESULTS: Out of the 14,067 pregnancies reviewed, the prevalence of teenage pregnancy was 2.8%. The mean age of the teenagers was 17.5 (±1.4) years, 243 (61.5%) of them had completed secondary school. Majority 286 (72.4%) delivered via spontaneous vaginal delivery, while 73 (18.5%) and 36 (9.1%) delivered via caesarean section and instrumental delivery respectively. The commonest complications encountered among the pregnant teenagers were perineal laceration (23.3%), iron deficiency anemia (17%) and delivery of low birth weight infant (14.9%). The younger teenagers were twice at risk of iron deficiency anaemia {OR (95%CI); p = 2.60 (1.08-5.92); p=0.028}. A similar association was seen between the age of the teenagers and route of delivery {OR (95%CI); p = 3.11 (1.34-6.93); p=0.002}, delivery of low birth weight infant {OR (95%CI); p = 3.12 (1.28-7.15); p=0.003} and perineal laceration {OR (95%CI); p = 2.54 (1.13-5.55); p=0.010}. CONCLUSION: Teenage pregnancy is associated with high risk of complications, especially among younger teenagers. Increasing public awareness as well as improving educational, socio- economic and reproductive health opportunities for adolescent girls is recommended.

INTRODUCTION: Cette étude a déterminé la prévalence, caractéristiques obstétriques et les résultats de la grossesse chez les adolescente qui ont accouché dans un établissement de santé secondaire de l'État du Delta du Nigeria. MATÉRIEL ET MÉTHODES: Une étude rétrospective a été employé pour examiner les grossesses prises en charge à l'hôpital central de Warri dans l'État du Delta, au Nigeria, entre 2014 et 2017. Les notes des patientes ont été récupérées et analysées en ce qui concerne les caractéristiques sociodémographiques, la grossesse, les complications et l'issue fœtale. Le test du chi-deux a été utilisé pour testé l'association entre les variables indépendantes et les principaux résultats de l'étude, la signification statistique étant fixée à p<0,05. RÉSULTATS: Sur les 14 067 grossesses examinées, la prévalence de la grossesse chez les adolescentes était de 2,8 %. L'âge moyen des adolescentes était de 17,5 (±1,4) ans, 243 (61,5%) d'entre elles avaient terminé l'école secondaire. La majorité des 286 (72,4 %) ont accouché par accouchement vaginal spontané, 73 (18,5 %) et 36 (9,1 %) ont accouché par césarienne et par accouchement instrumental respectivement. Les complications les plus courantes rencontrées chez les adolescentes enceintes ont été les lacérations périnéales (23,3%), l'anémie ferriprive (17 %) et l'accouchement d'un enfant de faible poids de naissance (14,9 %). Les adolescentes les plus jeunes étaient deux fois plus exposées au risque d'anémie ferriprive {OR (95%CI); p = 2,60 (1,08­5,92); p=0,028}. Une association similaire a été observée entre l'âge des adolescents et la voie d'accouchement {OR (95%CI); p = 3,11 (1,34­6,93); p=0,002}, l'accouchement d'un enfant de faible poids de naissance {OR (95%CI); p =3,12 (1,28­7,15); p=0,003} et lacération périnéale {OR (95%CI); p = 2,54 (1,13­5,55); p=0,010}. CONCLUSION: La grossesse chez les adolescentes est associée à un risque élevé de complications, en particulier chez les jeunes adolescentes. La sensibilisation du public ainsi que l'amélioration de l'éducation, socio-économiques et de santé reproductive pour les adolescentes est recommandée. Mots clés: Résultat obstétrical, Prévalence, Grossesse chez lesadolescentes.

Preferences, Utilization and Factors affecting Use of Contraceptives amongWomen attending Primary Health Care Facilities in Delta State,Southern Nigeria

Contraceptive use has numerous benefits for thefamily and the nation that can be maximized with its consistent use.However, many women have preferences for certain contraceptiveswith implications for continued use.OBJECTIVE: To determine the contraceptive preferences of women,their utilization pattern and factors affecting utilization of the preferredcontraceptive choices.METHODS: This cross-sectional study was conducted among 426women of reproductive age selected from 32 primary health facilitiesusing multistage sampling technique. Data was collected using a semi-structured interviewer-administered questionnaire. Descriptive andinferential analysis of data collected was carried out using IBM SPSSversion 22 software. P-value was set at 0.05.RESULTS: Close to half of the respondents 211 (49.5%) preferredinjectable contraceptives, 79 (18.6%) selected implants and 27 (6.3%)chose condoms. The majority 212 (49.8%) of respondents usedinjectable contraceptives, followed by implants 66 (15.5%), condoms33 (7.7%), IUCD 54 (12.7%) and OCP 61 (14.3%). Age (p<0.001),number of children (p<0.001), clients' employment status (p<0.001),husband support (p<0.021) and desire for more children (p<0.001)were all statistically associated with the utilization of preferredcontraceptives.CONCLUSION: Even though respondents preferred the injectablecontraceptives, implants and IUCD in that order, their utilizationpattern followed the order of Injectable, implants and OCP. Severalfactors were identified to be statistically associated with the utilizationof preferred contraceptives. Health education on contraceptive useamong women, spousal support and health workers training tohighlight those factors influencing women's contraceptive preferencesand utilization are recommended

Knowledge and practice of prophylaxis of deep venous thrombosis: A survey among Nigerian surgeons.

BACKGROUND: Venous thromboembolism is a potentially dangerous condition that can lead to preventable morbidity and mortality among surgical patients. OBJECTIVES: We aimed to determine the knowledge and practice of surgeons practising in Tertiary Hospitals in Nigeria about prophylaxis of deep vein thrombosis (DVT). MATERIALS AND METHODS: Eight Tertiary Institutions were selected from institutions in the geopolitical regions of the country by simple random sampling using balloting method. A semi-structured questionnaire was administered, and the response was obtained from 105 out of 254 surgeons. RESULTS: The mean knowledge score was 5.81 ± 1.67, and only 33.3% have good knowledge about DVT prophylaxis. No statistical difference was observed between the different groups of surgeons. The mean practice score was 5.19 ± 1.8 and only 20% of surgeons have a good practice of DVT prophylaxis. The majority (90.5%) have encountered DVT whereas 83.5% have encountered pulmonary embolism in their practice. Most commonly encountered risk factors include prolonged immobility, advanced age, and pelvic surgery. Only 13.3% have used Well's score in the clinical evaluation of their patients. The prophylactic modality adopted varies, but most surgeons (77%) utilized both the pharmacological and mechanical methods. Low molecular weight heparin is the commonly used chemoprophylactic agent while a combination of early ambulation and limb physiotherapy is the most commonly preferred mechanical method of thromboprophylaxis. CONCLUSION: There is a deficiency in the knowledge and practice of DVT prophylaxis among surgeons in Nigeria. There is a need to improve both the knowledge and practice by introducing institutional guidelines or protocol for DVT prophylaxis for surgical patients.

Assessment of knowledge and sexual behaviour among undergraduates in a Nigerian tertiary institution.

Background and Introduction: The achievement of the Millennium Development Goals (MDGs), particularly goals 5 and 6, is strongly underpinned by the progress that can be made on sexual and reproductive health education of young adults. The large population of young single adults in tertiary institutions in Nigeria and the present dearth of human resources for health necessitates that interventions for this group of individuals are tailored to meet identified gaps in awareness and sexual behaviour. This study sets out to assess the sexual behaviour and practice among single-undergraduates in a tertiary institution in Nigeria. Method: A descriptive cross sectional study was carried out among 410 consenting students selected through a multistage sampling method. Data was collected using a structured self- administered questionnaire and analysed using Statistical Package for Scientific Solutions (SPSS) version 16.0. Results: Mean age of respondents was 20 + 4.4 years, 228 (55.6%) were females and 182 (44.4%) males. The respondents' awareness of contraceptive devices was 81.7% (335) for condoms and less than 20% knew about other forms of contraception such as intrauterine device, tubal ligation and vasectomy. Over 65.7% (270) opined abstinence and use of condom to be the ideal methods for prevention of HIV/AIDS/ STI transmission. The overall mean age at first sexual contact was 14.0+1.4((14.2+1.6) in males and (13.8 +1.2) in females). A Very high proportion of sexually active respondents (93.6%) volunteered they do not routinely use condom in their sexual encounter. Undesired pregnancies occurred in about 11% of females. Recommendations: There is an urgent need for the establishment of specially designated youth friendly centres in the tertiary institutions in the country, manned with staff appropriately trained in the delivery of reproductive health information and services.

Awareness, ownership and utilization of insecticide treated nets in Abavo community of Delta State.

BACKGROUND: Despite free distribution of insecticide treated nets in Nigeria, the use it as a means of malaria prevention and control has not been fuIly embraced. AIM: The aim of this survey was to determine the level of awareness, ownership and utilization of insecticide treated nets among residents of Abavo community, Delta State Nigeria METHOD: It is a descriptive cross-sectional survey conducted among 250 heads of households. RESULT: One hundred and seventy five (70%) respondents were aware of insecticide treated net as a means of prevention against malaria, 111 (44%) claimed to own insecticide treated nets. On further inspection of houses of those who claimed to own ITNs, seventy four (66%) actually had theirs hanged, the rest were either in their packs or not seen. Ninety five (38%) respondents out of the total sleep under insecticide treated net. About 92 (70%) households having under-five and 39 (81.3%) of households having pregnant women claim to use ITNs. It was observed that the level of education (chi2 = 48.35, p = 0.001), presence of under 5 children in a household ?2 = 7.229, p = 0.027) influenced ownership of Insecticide treated nets. In conclusion despite a high level of awareness about ITN found in this survey, ownership and utilization of insecticide treated nets were low.