Girls at risk: FGM intentions among in-school adolescents of a rural community in Osun State, Nigeria.

PURPOSE: Knowledge of adolescents' intention to sustain female genital mutilation (FGM) practice is required to guide efforts to eradicate FGM in Africa and Asia where about 200 million women are affected. Nigeria has one of the highest FGM cases in the world. The study sought to determine the knowledge, attitude, and intentions of adolescents to sustain FGM practice when they become parents. MATERIALS AND METHODS: This study is a cross-sectional descriptive survey of 195 in-school adolescents aged 14-19 years, in Imesi-Ile, a rural town in South-west Nigeria selected through a multistage sampling method. RESULTS: Overall, 44.6% of adolescents had good knowledge of FGM, while 44.6% had a positive attitude and 55.4% had a negative attitude towards FGM. More females (57.4%) have a negative attitude towards FGM. About 42.1% of adolescents intend to continue the practice of FGM, while 47% have no intentions and 10.8% remain undecided. Gender, age group and family affluence were not statistically associated with intention to continue FGM. CONCLUSION: Intention to continue FGM practice is high among adolescents in the rural community. FGM eradication campaign among adolescents should seek to improve knowledge, attitude and intentions towards FGM practice.

Comparative Assessment of Echocardiographic Patterns Among Chronic Myeloid Leukemia Patients on Tyrosine Kinase Inhibitor and Healthy Controls.

PURPOSE: Chronic myeloid leukemia (CML) is one of the common hematological malignancies in Nigeria. Cardiac abnormalities are associated with CML irrespective of treatment with tyrosine kinase inhibitors such as imatinib, which is available gratis in Nigeria. OBJECTIVE: To assess the prevalence and patterns of cardiac dysfunction among patients with CML irrespective of treatment with imatinib using transthoracic echocardiography, and 12-lead surface electrocardiography. PATIENTS AND METHODS: CML patients without Imatinib, CML patients with imatinib, and apparently healthy (age- and sex-matched) controls were 70 each in the study. Various echocardiographic parameters were measured and data obtained were analyzed, and the level of significance was taken as p < 0.05. RESULTS: Of 70 CML patients with imatinib, 54.3% were men and 45.7% were women, while the CML group without imatinib had 62.9% men and 37.1% women, non-CML control had 54.3% men and 45.7% women. The average hematocrit was significantly lower in the CML group without Imatinib compared with the other groups (p<0.001). And, 12.9% and 17.1% of CML groups with and without imatinib had LVH, respectively, and none of the non-CML controls had LVH (P<0.041). Impaired left ventricular relaxation in 25.71% and 28.57% of CML patients with and without imatinib respectively but only 8.57% of the non-CML control had impaired left ventricular relaxation (p=0.236). Mitral valve regurgitation was the most frequent valvular abnormality across the groups. Pulmonary hypertension in 17.4% and 20% of CML patients with and without imatinib, respectively, but none of the non-CML controls had pulmonary hypertension (p<0.001). Pericardial effusion in 32.86% and 45.71% of CML patients with and without imatinib, respectively, but none of the non-CML controls had pericardial effusion (p<0.001). There was no significant difference in the QTC interval across the three groups. CONCLUSION: Cardiac abnormalities are present in CML patients with or without Imatinib treatment, with significant prevalence than what is seen in the non-CML control group.

Eight-hour versus 24-h urethral catheter removal following elective caesarean section for reducing significant bacteriuria: A randomized controlled trial.

BACKGROUND: There is no consensus on the preferred time to remove urethral catheter post caesarean section. AIM: To compare rate of significant bacteriuria and urinary retention following 8-h (study) and 24-h urethral catheter removal (control) post elective caesarean section. METHODS: A randomized controlled trial of eligible participants that underwent elective caesarean section under spinal anaesthesia between March 2019 and November 2019 was conducted. Participants (150 in each arm) were randomly assigned (1:1 ratio) to either 8-h or 24-h group. Primary outcome measures included rates of significant bacteriuria 48-h post-operatively and acute urine retention 6-h post urethral catheter removal. Analysis was by Intention-to-treat. (www.pactr.org:PACTR202105874744483). RESULTS: There were 150 participants randomized into each arm and data collection was complete. Significant bacteriuria was less in 8-h group (3% versus 6.0%; risk ratio (RR): 0.85 CI: 0.60 to 5.66; p = 0.274), though not significant. Acute urinary retention requiring repeat catheterisation was significantly higher in 8-h group (11(7.3%) versus 0(0.0%); RR: 0.07; CI: 0.87 to 0.97; p = 0.001). Mean time until first voiding was slightly higher in 8-h group (211.4 ± 14.3 min versus 190.0 ± 18.3 min; mean difference (MD): 21.36; CI: -24.36 to 67.08; p = 0.203); but patient in this group had a lower mean time until ambulation (770.0 ± 26.1 min versus 809 ± 26.2 min; MD: -38.8; CI: -111.6 to 34.0; p = 0.300). The 8-h group were significantly more satisfied (82/150 (54.7%) versus 54/150 (36.0%); p = 0.001). CONCLUSIONS: An 8-h group was associated with significant clinical satisfaction and acute urine retention compared to 24-h removal. The timing of urethral catheter removal did not affect rate of significant bacteriuria and other outcomes.

Knowledge of primary healthcare workers regarding the prevention and control of non-communicable diseases in Osun State, Nigeria: A rural-urban comparison.

BACKGROUND: There is a rising burden of non-communicable diseases (NCDs) in the sub-Saharan Africa, and calls for integration of management of selected NCDs with primary healthcare (PHC) have been unrelenting. Cost-effective interventions for the prevention and control of NCDs can be delivered at PHC facilities in low-resource settings by clinical healthcare workers (HCWs). AIM: This study compared the knowledge of HCWs in PHC facilities regarding the prevention and control of NCDs in rural and urban local government areas (LGAs) of Osun State. SETTING: A comparative cross-sectional study was conducted amongst 400 eligible HCWs recruited using a multistage sampling technique in PHC facilities of six rural and six urban LGAs. METHODS: A pretested self-administered case-scenarios questionnaire was used to assess the knowledge of HCWs regarding the prevention and control of three selected NCDs (diabetes, hypertension and chronic respiratory diseases). Both descriptive and inferential statistics were conducted. RESULTS: The mean knowledge scores of HCWs regarding the prevention and control of the three NCDs were 17.76 ± 4.41 in rural and 17.62 ± 4.02 in urban LGAs out of 30 maximum scores. The proportion of HCWs with adequate knowledge in the rural LGAs (31.0%) was slightly higher than the urban LGAs (23.0%); however, it was not statistically significant (χ2 = 3.247; p = 0.072). The major determinants of adequate knowledge include cadre of HCWs, location, years in practice with professional certificate, NCD training course attendance and reported experience managing diabetic patients. CONCLUSION: The HCWs in PHC facilities in rural and urban LGAs of Osun State, Nigeria, had a poor knowledge regarding the prevention and control of NCDs. Training and re-training of less-skilled HCWs in the PHC facilities using relevant WHO NCD protocols and guidelines are imperatives to improve their knowledge about the prevention and control of NCDs.