Marital disruption--the welfare of the children thereafter in Nigeria.

Departure from the traditional society is being witnessed in Nigeria and many cultural values and control are being lost. Many marriages are contracted between the individuals as opposed to between families, and so poorly withstand the test of time and stress of modern day living, hence more children witness family disruption than before. One thousand randomly selected State Social Welfare case records were studied in depth and information regarding the socioeconomic and demographic characteristics of the families, the nature of their problems, welfare status of the children including paternal contribution for their maintenance were extracted, collated and analyzed. Some important variables were also cross-tabulated. Young maternal age was found to statistically influence the type of case/nature of complaint and the living arrangement of the children (p = .001 and p = .00035 respectively). Income level of the mother also affected the type of case/nature of complaint significantly (p = .00001). About 53.6% of the cases were for maintenance and 23.1% for custody. Most of the children were underage; 56.8% of the first born were under 5 years of age. Single custody was commonly practiced, 63.6% of the children lived with their mothers only and 10.2% with their fathers only before intervention, thereafter 16 of those living with their mothers only were transferred to their fathers. Only .09% of the women remarried and about half of these women had children from their previous marriages living with them; some had their new husbands helping with maintenance. Many of the biological fathers were not responsible for the maintenance of their children and the few that were defaulted regularly. The mothers had to seek redress; the steps taken included social welfare intervention (95.5%), police and legal (4%), and family intervention (0.3%). The inadequacy, inappropriateness, and obsolete nature of our social laws were highlighted by this study. Therefore, urgent attempts at revising and reforming them in line with the demands of the society vis-à-vis our level of development and improving standards of living are strongly recommended.

AIDS: awareness and blood handling practices of health care workers in Lagos, Nigeria.

A questionnaire survey of 260 health care workers from 13 randomly selected health care facilities was undertaken. Their knowledge, attitude, belief and blood handling practices regarding HIV/AIDS were enquired about. Virtually all (99.0%) respondents had heard about AIDS but only 57.0% had seen an AIDS patient before. Although 83.0% knew that AIDS is caused by a virus, a high proportion still confuses mode of transmission with causative agent. Deficient knowledge was exhibited when asked about groups of people who were at a higher risk of contracting HIV and AIDS: Only 54.6% and 51.5% identified homosexuals and i.v. drug users as being at a higher risk. Almost all (97.0%) of our respondents claimed to have been more careful in their blood handling practices since the emergence of AIDS, 68.5% wore gloves for all procedures involving handling of blood and 28.5% sometimes although as many as 30.4%, 40.4% and 18.1% do not wear gloves for cleaning up blood stained materials, nursing procedures and taking obstetric delivery respectively. It was evident from their responses that not all the health workers knew the correct method for disposing of used bloodstained instruments and left-over blood samples and neither were they all adhering to the safety guidelines recommended for handling these materials. Education of all health care workers in Nigeria on the Universal Precautions Guidelines issued by the Centers for Disease Control (CDC) in 1987 regarding blood, body fluids and contaminated instruments' handling precautions is urgently recommended.

Ethnographic study on childhood diarrhoeal diseases in a rural Nigerian community.

Mothers in thirty households in a rural Nigerian community were subjected to ethnographic studies on food handling practices as they relate to diarrhoeal diseases in children. The study had a first phase of three open-ended unstructured interviews each lasting about 2 hours and a second phase of direct observations on food handling practices during preparation, administration and storage by mothers. Results indicated that as many as 20 (66.7%) of the mothers identified diarrhoea as a common cause of childhood diseases. Diarrhoea due to food contamination was recognized by as many as 18 (60.0%) respondents. Four important food handling practices relating to water treatment, handwashing before preparation and feeding, administration and storage were recognized in the first phase but the claimed practices in the first phase differed significantly from the observed practices in the second phase (p < 0.025). Many (32.1%) mothers had contaminating food handling behaviours. The low literacy level, poverty and lack of good personal hygiene among the studies population were the most likely causes of the behaviours observed.

Bacteriological study of cooked ogi (fermented cereal weaning food) and its potential safety in a rural Nigerian community.

Thirty households with children receiving the fermented cereal food ogi were selected randomly from Ajara, a rural community in Lagos State, Nigeria. Eighty-one samples of ogi were collected from these households at the time of administration to the children. The degree of bacteriological contamination and pH values of the cooked ogi samples were determined. The mean pH was 3.6 +/- 0.2. Faecal coliform contamination levels of 3 to > or = 2400/ml were recorded in 26 (31.3%) of the 81 ogi samples. Levels of faecal coliforms increased significantly (P < 0.025) during storage of cooked samples for 9 h. The high contamination rate is unacceptable and is a potential health hazard. Although fermenting food like ogi, resulting in a low pH, may reduce bacterial contamination, hygienic practices during handling and preparation should be emphasized as adjuncts in intervention for control of diarrhoeal disease in developing countries.

Assessment of post-vaccination tuberculin sensitivity in Lagos-Nigeria.

An increase in the number of cases of tuberculosis, especially in children, has been observed recently. Post-vaccination conversion rate in babies immunised with BCG was assessed. Sensitization was detected as early as 4 weeks after BCG inoculation. Although 84.2% had physical evidence of BCG inoculation only 69.8% had developed detectable sensitization to the tubercle bacilli as shown by the Mantoux test.

Study on the pH of ogi, Nigerian fermented weaning food, and its effect on enteropathogenic Escherichia coli, Salmonella typhi and Salmonella paratyphi.

The pH values of both cooked and uncooked ogi samples were determined and the survival of nalidixic acid-resistant enteropathogenic Escherichia coli OB 26 34/20, Salmonella typhi and Salmonella paratyphi A when seeded into cooked ogi were studied. The pH values of ogi ranged from pH 3.0 to 3.9. Cooked ogi had a slightly lower pH value than uncooked ogi. Our survival experiments showed that the inoculated enteric pathogens were considerably inhibited in cooked ogi during storage for 24 h. The antibacterial effect of cooked ogi was more pronounced on enteropathogenic E. coli with a log10 5 decline in bacterial count within 6 h.

Epidemiologic survey of menstrual patterns amongst adolescents in Nigeria.

Nine hundred and fifty secondary school girls aged between 10 and 18 years were randomly selected and surveyed. Information on their age at menarche, regularity of menstruation at onset and the time of survey and length of period of irregularity were sought using a well structured questionnaire. Estimation of blood loss per period premenstrual symptoms and signs, prevalence and severity of dysmenorrhoea were also inquired about. This study demonstrated a secular trend in the age at menarche when compared with other similar studies conducted in the previous decade in Nigeria. A higher prevalence of 71.8% of any grade of dysmenorrhoea was found in this study when compared with figures from developed countries, this and the short mean duration of irregular menstruation (3.7 months after menarche) were taken to be evidence of early establishment of regular ovular menstruation.

Sexual activity, contraceptive practice and abortion among adolescents in Lagos, Nigeria.

Nine hundred fifty randomly selected secondary school girls were surveyed. Sexual activity was claimed by 29%, the youngest age was 12 years and age had no influence on the frequency of sexual intercourse. Multiple sexual partners, a high risk behaviour for contracting STD including AIDS was demonstrated in 33.7% and only 20.3% used orthodox methods of contraception. Induced abortion was procured by 23.5% and most were procured from unskilled personnel and by dangerous methods.

Adolescents AIDS knowledge, attitude and beliefs about preventive practices in Nigeria.

Three hundred ninety-eight randomly selected Nigerian adolescents were surveyed using well structured questionnaires to collect all information on their knowledge, attitude, beliefs and practice regarding AIDS. The questionnaires were carefully administered and analysed. Most of the respondents, aged 10-20 years, were born in metropolitan cities (83.9%), grew up in such cities (93.2%) and have always lived in them (92.7%). Only 37.9% of them knew the causative agent of AIDS, although 96% claimed to have heard of the disease called AIDS. Seventeen percent (17%) knew all the important routes of transmission and 19.1% identified the groups at high risk for contracting AIDS. Limited knowledge and practice of preventive measures were demonstrated. AIDS was identified as a serious health problem for the world but not yet for Nigeria. Nigerian urban youths have been found to be sexually active with multiple sexual partners. Their knowledge of AIDS is limited, and few of them practice preventive measures. They should, thus, be regarded as a high risk group. Coordinated health education programmes coupled with communication and involvement of these youths should be urgently undertaken.

PIP: 398 adolescents from 8 secondary schools in Lagos, Nigeria were surveyed to assess their knowledge, attitudes, beliefs, and practices of preventive measures in terms of AIDS and to evaluate AIDS education efforts. None of the students thought AIDS was a serious health problem in Nigeria, but 84.2% thought it was the most serious health problem in the world. 96% were aware of AIDS, yet just 37.9% knew that it is caused by a virus. Only 17.1% knew that sexual intercourse, blood transfusions, and mother to child were 3 transmission routes for AIDS. In fact, more students (21.8%) did not know any route. Just 19.1% knew that prostitutes, homosexuals, and drug abusers were groups at high risk of acquiring AIDS, and most teenagers (34.7%) could not identify any high risk groups. Only .7% (3) realized using condoms could prevent AIDS, but 73% (111) of the 152 students who said family planning methods could prevent AIDS mentioned condoms as an AIDS prevention method. 64.1% thought that changes in behavior or life style can prevent AIDS, yet 20% of these students did not know what changes needed to be done to prevent AIDS. 40.7% of the teenagers said they had changed their life style or some behaviors once they heard about AIDS. The main change was not having sexual intercourse with prostitutes. 52.3% believed they would never get AIDS. 33.2% of the students did not list a source of information on AIDS. 41.7% received information from the mass media, especially television and newspapers/periodicals. To effect behavior and life style changes, public health professionals should plan information, education, and communication programs on AIDS which provide accurate information to correct misconceptions and to promote prevention practices.

Faecal contamination level; survival of salmonella typhi and pH changes in 'Gari' and its potential public health hazard in Lagos

The pH changes; faecal contamination level; survival of nalidixic-acid resistant salmonella typhi in 'gari' soaked in water was examined. The pH values showed that 'gari' had a range of pH 3.76 to pH 6.24. The mean pH values showed that there were no appreciable change for gari types from various sources within the studied time period of 120 minutes. Faecal coliform contamination of 4 to 2;400/g using the MPN technique were recorded in 33of the 36 'gari' samples. This high faecal coliform contamination rate of gari; a popular fermented cassava food is unacceptable and it is of public health importance. Our survival experiment showed that the seeded enteric pathogen slightly decreased in colony-forming unit (cfu) with log(0.3 10) 0.3 within the studied 120 minutes. It is concluded that our local foods should be monitored regularly for public health safety; and improved hygienic practices should be emphasized as an intervention for diarrhoeal diseases in developing countries

A study on female circumcision in Nigeria.

A total of 181 women were randomly chosen from the women attending the family planning clinic of the Department of Community Health, College of Medicine, University of Lagos, from February 1984 to September 1984. Of these, 84.7% were aged between 25 and 44 years and most of them are Yorubas (70.7%). A high proportion (56.4%) claimed to have been circumcised but examination revealed that 24.5% had no clinical evidence of circumcision. The Edo tribe had the highest proportion circumcised amongst the respondents, 76.7%, followed by the Ibos, 61%, and least of all the Efiks, 20%. Age at circumcision revealed that most had their circumcision as infants (78.8%) and only 5.9% had theirs as adults, however, the Ibos and Yorubas had high rates of infant circumcision. Some of the respondents were aware of the associated side effects and it was found that the more educated women were less likely to circumcise their daughters. All circumcised daughters were from circumcised mothers except one and she had to circumcise her daughter in conformity with her husband's tribal practice. Accurate statistics of morbidity and mortality from female circumcision will be difficult to gather as circumcision is performed mostly in the houses, nevertheless, the complications are severe enough to merit authoritative intervention. It is recommended that public awareness of female circumcision, its complications and other attendant health hazards should be embarked upon by health authorities especially amongst the tribes practising it.

PIP: A total of 181 women were randomly chosen from the women attending the family planning clinic of the Department of Community Health, College of Medicine, University of Lagos, from February-September 1984. Of these, 84.7% were between 25-44 years of age and most of them were Yorubas (70.7%). A high proportion (56.4%) claimed to have been circumcised by examination revealed that 24.5% had no clinical evidence of circumcision. The Edo tribe had the highest proportion circumcised among the respondents, 76.75 followed by the Ibos, 61% and lastly the Efiks, 20%. Age at circumcision revealed that most had their circumcision as infants (78.8%) and only 5.9% has theirs when adult; the Ibos and Yorubas had the highest rates of infant circumcision. Some of the respondents were aware of the associated side effects and it was found that the more educated women were less likely to circumcise their daughters. All circumcised daughters were from circumcised mothers with the exception of 1 and she circumcised her daughter in conformity with her husband's tribal practice. Accurate statistics of morbidity and mortality from female circumcision will be difficult to gather as circumcision is performed mostly in the houses. Nevertheless, complications are severe enough to merit authoritative intervention. It is recommended that public awareness of female circumcision, its complications, and other attendant health hazards should be issues dealt with by health authorities, especially among the tribes who practice it. (author's modified)