E-cigarette, cigarette, dual e-cigarette with cigarette use, and disability status among reproductive-aged women.

OBJECTIVE: E-cigarettes have increased steadily among reproductive-aged women, despite our limited understanding of their effect on reproductive health. This study examined the associations of e-cigarette, cigarette, and dual use with disability in reproductive-aged women. STUDY DESIGN: This was a cross-sectional study. METHODS: Data for this study were obtained from reproductive-aged women (18-44 years; n = 24,904) from the 2020 Behavioral Risk Factor Surveillance System. Descriptive statistics and logistic regression analyses were conducted to assess the associations of tobacco use patterns (dependent variable, i.e. non-use, current e-cigarette use, current cigarette use, and current dual use of e-cigarettes and cigarettes) with overall disability and the type of disability (independent variables). RESULTS: Among women who reported any disability, 70.6%, 8.7%, 11.4% and 9.3% reported non-use, e-cigarette, cigarette, and dual use, respectively. In adjusted analysis, relative to non-use, women who reported any disability had higher odds of e-cigarette (adjusted odds ratio [aOR]: 1.88; 95% confidence interval [CI]: 1.15-3.07), cigarette (aOR: 1.58; 95% CI: 1.12-2.25), and dual use (aOR: 2.37; 95% CI: 1.55-3.62) compared with women without disabilities. CONCLUSIONS: This cross-sectional study found higher odds of current e-cigarette use, cigarette use, and dual use of e-cigarettes and cigarettes among women of reproductive age with ≥1 disability. Improved screening for the use of nicotine products among women of reproductive age with disabilities may be necessary to lessen the use of nicotine products in this vulnerable population.

Community Advocacy and Capacity Building of Community Health Workers on Rheumatic Heart Disease in Osun State, Nigeria.

Rheumatic heart disease (RHD) is one of the leading causes of cardiovascular diseases in the world. The study aimed to assess awareness and capacity building on the diagnosis and prevention of RHD among Community Health Workers (CHWs) Nigeria. It was an interventional study, where 300 CHWs from public Primary Health Care (PHC) facilities were selected pre-assessed on the diagnosis and prevention of RHD before their training on RHD. Also, a post-test evaluation was done to reassess the CHWs awareness on RHD. Data were analyzed and RHD knowledge was scored and graded. Results showed, at pre-test evaluation, that 49% of the CHWs had good knowledge, 49.7% had fair knowledge while 4.1% had poor knowledge on the diagnosis and prevention of RHD, while post-test evaluation revealed that 100% of the CHWs had good knowledge. Awareness of the CHWs about the diagnosis and prevention of RHD was fair in the pre-test and improved after the training with all the CHWs having good knowledge. This showed the training was impactful. Intermittent assessment of the awareness and simultaneous training of the CHWs on RHD may be scaled up into a significant and effective measure in the armamentarium of community prevention of the disease.

La cardiopathie rhumatismale est l'une des principales causes de maladies cardiovasculaires dans le monde. L'étude visait à évaluer la sensibilisation et le renforcement des capacités sur le diagnostic et la prévention de la cardiopathie rhumatismale chez les agents de santé communautaire (ASC). au Nigeria. Il s'agissait d'une étude interventionnelle, dans le cadre de laquelle 300 ASC des établissements publics de soins de santé primaires (PHC) ont été sélectionnés et pré-évalués sur le diagnostic et la prévention des RHD avant leur formation sur les RHD.. De plus, une évaluation post-test a été réalisée pour réévaluer la connaissance des ASC sur la RHD. Les données ont été analysées et les connaissances sur la RHD ont été notées et évaluées. Les résultats ont montré, lors de l'évaluation du pré-test, que 49% des ASC avaient une bonne connaissance, 49,7 % une connaissance moyenne et 4,1 % une mauvaise connaissance du diagnostic et de la prévention de RHD, tandis que l'évaluation du post-test a révélé que 100% des ASC avaient de bonnes connaissances. La connaissance des ASC sur le diagnostic et la prévention de la RHD était moyenne dans le pré-test et s'est améliorée après la formation, tous les ASC ayant de bonnes connaissances. Cela montre que la formation a eu un impact. L' évaluation intermittente de la sensibilisation et la formation simultanée des ASC sur la RHD peut devenir une mesure significative et efficace dans l'arsenal de prévention communautaire de la maladie. Mots-clés: Cardiopathie rhumatismale, Agents de santé communautaire, service de santé, prévention.

Efficacy of Hexetidine, Thymol and Hydrogen Peroxide-Containing Oral Antiseptics in Reducing Sars-Cov-2 Virus in the Oral Cavity: A Pilot Study.

BACKGROUND: Studies have demonstrated the role of sputum as a site of severe acute respiratory syndrome-coronavirus-2 (SARSCoV-2) transmission. However, there is limited literature on the virucidal efficacy of oral antiseptics against SARS-CoV-2 virus. This study investigated the virucidal efficacy of three oral-antiseptics compared to a placebo-control in the sputum of SARS-CoV-2 infected individuals. METHODOLOGY: A pilot study of adults with SARS-CoV-2 positive results, as determined by reverse transcription-polymerase chain reaction (RT-PCR) of <7 days. The oral antiseptics investigated were: Hexetidine (0.1% w/v); Thymol (0.063% w/v) and H2O2(1.5%) compared to de-mineralized sterile water (Placebo-control). The primary outcome measure was the proportion of negative RT-PCR results at 15-mins, 30-mins, 1-hour, 2-hours and 4-hours After Oral antiseptics Interventions (AOI) compared to the placebo-control. Statistical analysis was done using STATA 15.0 software with p-values of <0.05 considered statistically significant. RESULTS: Data from a total of 66 participants that were RT-PCR SARS-CoV-2 positive at baseline (0-min) was analysed. At 15-mins AOI, the highest proportion of negativation from sputum samples was observed in the Hexedine group, with 69.2% of the baseline PCR positive cases converting to negative compared to 46.7% in the placebo-control group. In addition, H2O2 demonstrated efficacy at 2-hours AOI compared to placebo-control (62.5% vs 37.5% respectively) and other oral-antiseptics. Across all time-points, the oral-antiseptic groups compared to the placebo-control group, there was no statistically significant difference in the proportion of sputum samples which converted to a negative status (p>0.05). CONCLUSION: The findings in this study suggest there was no significant difference in the proportion of participants who converted to a negative sputum status across the treatment groups at various time points. Future studies could compare the cycle threshold (ct) viral titre values of sputum samples to determine quantitative differences.

CONTEXTE: Des études ont démontré le rôle des expectorations comme un site de transmission du syndrome respiratoire aigu sévère-coronavirus- 2 (SRAS-CoV-2). Cependant, il existe peu de documentation sur l'efficacité virucide des antiseptiques oraux contre le virus du SRASCoV-2. Cette étude a examiné l'efficacité virucide de trois antiseptiques oraux par rapport à un contrôle placebo dans les expectorations de personnes infectées par le SRAS-CoV-2. MÉTHODOLOGIE: Une étude pilote menée auprès d'adultes dont les résultats sont positifs pour le SRAS-CoV-2, tels que déterminés par la réaction en chaîne de la polymérase par transcription inverse (RT-PCR) pendant 7 jours. Les antiseptiques oraux étudiés étaient : Hexetidine (0,1% p/v) ; Thymol (0,063% p/v) et H2O2 (1,5%) par rapport à l'eau stérile déminéralisée (Placebo-contrôle). Le principal critère d'évaluation était la proportion de résultats RT-PCR négatifs 15 minutes, 30 minutes, 1 heure, 2 heures et 4 heures après les interventions antiseptiques orales (AOI) par rapport au contrôle placebo. L'analyse statistique a été réalisée à l'aide du logiciel STATA 15.0, les valeurs p de <0,05 étant considérées comme statistiquement significatives. RÉSULTATS: Les données d'un total de 66 participants qui étaient positifs à la RT-PCR SARS-CoV-2 au départ (0 minute) ont été analysées. Au bout de 15 minutes, la plus forte proportion de négativation des échantillons d'expectoration a été observée dans le groupe Hexedine, 69,2 % des cas positifs au départ par PCR devenant négatifs, contre 46,7 % dans le groupe témoin placebo. En outre, l'H2O2 a démontré son efficacité à 2 heures après l'apparition de la maladie par rapport au groupe placebo (62,5 % contre 37,5 % respectivement) et aux autres antiseptiques oraux. Pour tous les points temporels, les groupes d'antiseptiques oraux comparés au groupe placebo n'ont pas présenté de différence statistiquement significative dans la proportion d'échantillons d'expectoration qui sont devenus négatifs (p>0,05). CONCLUSION: Les résultats de cette étude suggèrent qu'il n'y a pas de différence significative dans la proportion de participants qui sont passés à un statut négatif d'expectoration dans les groupes de traitement à différents moments. Les études futures pourraient comparer les valeurs du titre viral au seuil de cycle (ct) des échantillons d'expectoration afin de déterminer les différences quantitatives. MOTS CLÉS: SRAS-CoV-2, antiseptiques oraux, hexétidine, peroxyde d'hydrogène.

A multi-centre, randomized, double-blind, placebo-controlled clinical trial of the efficacy and safety of chloroquine phosphate, hydroxychloroquine sulphate and lopinavir/ritonavir for the treatment of COVID-19 in Lagos State: study protocol for a randomized controlled trial.

BACKGROUND: The coronavirus disease 2019 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that was first identified in Wuhan, Hubei, China, in December 2019. It was recognized as a pandemic by the World Health Organization on 11 March 2020. Outbreak forecasting and mathematical modelling suggest that these numbers will continue to rise. Early identification of effective remedies that can shorten the duration and severity of illness is critical for Lagos State, which is the epi-centre of the disease in Nigeria. METHODS: This is a multi-centre, randomized, double-blind placebo-controlled superiority trial. The study investigates the efficacy of chloroquine phosphate, hydroxychloroquine sulphate and lopinavir/ritonavir added on to standard of care compared to standard of care only in patients with COVID-19 disease. The primary outcome is the clinical status of patients measured using a 7-point ordinal scale at day 15. Research participants and clinicians will be blinded to the allocated intervention. Outcome measures will be directly assessed by clinicians. Statistical analysis will be done by a team blinded to the identity and allocation of research participants. Data analysis will follow intention-to-treat methods, using R software. DISCUSSION: The current study is of strategic importance for Lagos State in potentially curbing the health, social and economic burden of COVID-19 disease. Should the current study demonstrate that either of the three intervention drugs is more efficacious than standard therapy alone, the State Ministry of Health will develop an evidence-based guideline for the management of COVID-19 in Lagos State. The findings will also be shared nationally and with other states which may lead to a standardized national guideline for the treatment of COVID-19 in Nigeria. TRIAL REGISTRATION: Pan African Clinical Trials Register PACTR202004801273802 . Registered prospectively on April 2, 2020.

Exposure to Anti-Tobacco Messaging and Quit Attempts among Adolescent and Young Adult in Lagos, Nigeria: A Population-based Study.

BACKGROUND: Health behavior theories suggest that knowledge about the health risks of the behavior precedes behavior change. Tobacco control messages aim to promote knowledge of health risks associated with tobacco use and encourage smoking cessation behaviors such as quit attempts and intention to quit. This study assessed the relationship between exposure to Anti-Tobacco Messaging (ATM) and quit attempts among adolescents and young adults in Lagos, Nigeria. METHODS: This was an online cross-sectional survey of 947 participants aged between 15-35 years. The survey obtained sociodemographic information, smoking status, exposure to ATM, intention to quit and quit attempts in the past 12-months. Logistic regression analysis was used to identify the relationship between exposure to ATM and quit attempts; pvalues <0.05 were considered significant. Statistical analysis was done using STATA-15.0 software. RESULTS: The mean age of respondents was 23.4 years (SD:4.0). Less than one-third of the respondents were smokers (23.4%). The most common source of ATM were digital sources (online and social media - 29.6%). Based on the multivariable logistic regression model, younger age (p:0.03) and an intention to quit (p: <0.001) were significantly associated with a quit attempt. Exposure to ATM in the past 12 months was also significantly associated with higher odds of a quit attempt (OR:5.33; 95% CI: 1.26,22.60; p: 0.02). CONCLUSION: Our findings suggest an association between exposure to ATM and quit attempts among adolescent and young adult smokers in Lagos State, Nigeria. Policymakers should consider measures aimed at promoting tobacco control education and improving access to smoking cessation services.

CONTEXTE: Les théories du comportement en matière de santé suggèrent que la connaissance des risques sanitaires du comportement précède le changement de comportement. Les messages de lutte contre le tabagisme visent à promouvoir la connaissance des risques pour la santé associés au tabagisme et à encourager les comportements de renoncement au tabac tels que les tentatives d'abandon et l'intention d'abandonner. Cette étude a évalué la relation entre l'exposition aux messages antitabac (MTA) et les tentatives d'arrêt du tabac chez les adolescents et les jeunes adultes de Lagos, au Nigeria. MÉTHODES: Il s'agissait d'une enquête transversale en ligne auprès de 947 participants âgés de 15 à 35 ans. L'enquête a permis d'obtenir des informations sociodémographiques, le statut tabagique, l'exposition au MTA, l'intention d'arrêter et les tentatives d'arrêt au cours des 12 derniers mois. Une analyse de régression logistique a été utilisée pour identifier la relation entre l'exposition à la GTA et les tentatives d'abandon ; les valeurs p <0,05 ont été considérées comme significatives. L'analyse statistique a été réalisée à l'aide du logiciel STATA-15.0. RÉSULTATS: L'âge moyen des répondants était de 23,4 ans (écarttype:4,0). Moins d'un tiers des répondants étaient fumeurs (23,4%). La source de DAB la plus courante était les sources numériques (médias en ligne et sociaux-29, 6%). D'après le modèle de régression logistique multivariable, un âge plus jeune (p: 0,03) et une intention d'arrêter de fumer (p:<0,001) étaient significativement associés à une tentative d'arrêt. L'exposition à la GTA au cours des 12 derniers mois était également associée de manière significative à une probabilité plus élevée de tentative d'abandon (OR:5,33;IC à 95%: 1,26,22,60; p:0,02). CONCLUSION: Nos résultats suggèrent une association entre l'exposition à la GTA et les tentatives d'arrêt chez les fumeurs adolescents et jeunes adultes de l'État de Lagos, au Nigeria. Les décideurs politiques devraient envisager des mesures visant à promouvoir l'éducation à la lutte antitabac et à améliorer l'accès aux services d'aide au sevrage tabagique. Mots clés: Adolescent, Intention d'arrêter de fumer, Tentative d'arrêt du tabac, Jeunes, Tabac.

Health Insurance Knowledge, Attitude and the Uptake of Community-Based Health Insurance Scheme among Residents of a Suburb in Lagos, Nigeria.

BACKGROUND: Out of pocket payment for health services in the midst of financial hardship is a major contributor to poor access to healthcare in Nigeria with the resultant poor health indices. Towards the goal of Universal Health Coverage, Community Based Health Insurance (CBHI) was introduced in addition to the National Health Insurance Scheme but with minimal impact and utilization. OBJECTIVE: The objective of this study was to assess health insurance-related knowledge and attitudes and to examine the uptake of CBHI. METHODS: This was a descriptive cross-sectional study. A multi-stage sampling method was used to select 419 respondents from the Ajeromi-Ifelodun community. A semi-structured interviewer-administered questionnaire was used to collect data for the study. Data analysis was done using Microsoft Excel and Epi-Info 7.1. RESULTS: Most of the respondents (80.2%) had not heard of Community-Based Health Insurance and only about 9% of respondents had good knowledge about it. However, most (62.5%) of the respondents had a positive attitude towards health insurance generally. Only 4.5% of the respondents were enrolled in the CBHI scheme and had paid their premium up to date. There was a significant association between the respondents' knowledge and their uptake of the scheme (<0.001), and also between their attitudes and uptake (p = 0.002). CONCLUSION: This study suggests that for CBHI to be successful, certain strategies must be implemented towards increasing awareness and knowledge about CBHI. This will in turn increase the uptake of the scheme, a necessary requirement for achieving the goal of Universal Health Coverage.

Nutritional knowledge, dietary habits and nutritional status of diabetic patients attending teaching hospitals in Lagos, Nigeria

Background: This study assessed the nutritional knowledge, dietary habits and nutritional status of adult diabetic patients attending teaching hospitals in Lagos State, Nigeria. Methods: A cross-sectional study was conducted among adult diabetic patients attending the out-patient clinics of the two Teaching Hospitals in Lagos. Respondents were recruited from the clinics consecutively until the desired sample size (342) was obtained. A pre-tested interviewer-administered questionnaire was used to collect data. Dietary habits were assessed using food frequency questionnaire and BMI was assessed following standard procedure and compared with the World Health Organization (WHO) standards. Data was analyzed using IBM SPSS (Version 20). Chi-square and fisher's exact probability test were used to determine the association between variables. The level of significance was set at p-value less than 5%. Results: The mean age of the respondents was 59.6 + 13.0 years. Only 125 (37%) of the respondents had good nutritional knowledge. Majority ate three meals every day, 237 (69.3%) and have had dietary counseling, 255 (74.6%). More than half of the respondents, 202 (59.1%) skipped meals, 80 (23.4%) consumed alcohol while only 42 (12.3%) ate fruits and vegetables daily. The commonest food consumed was processed cereals. Majority of the respondents were overweight or obese (74%). Obesity was associated with being female and not having dietary counseling. Conclusion: Nutritional knowledge and dietary habits were poor while overweight and obesity were high. Dietary counseling will be necessary to improve the dietary pattern and nutritional status of the diabetic patients

Antihypertensive use, prescription patterns, and cost of medications in a Teaching Hospital in Lagos, Nigeria.

INTRODUCTION: Hypertension has been reported as the strongest modifiable risk factor for cardiovascular morbidity and mortality. AIMS: The aim of the study was to identify the most prescribed antihypertensive drugs, its patterns, comorbidities, cost of medications, and laboratory investigations. SETTINGS AND DESIGN: This study was a cross-sectional, descriptive study of hypertensive patients conducted at the Lagos State University Teaching Hospital, Ikeja. SUBJECTS AND METHODS: A total of 200 case notes were retrieved from the medical records unit over a period of 8 weeks. Information on antihypertensive prescriptions and comorbidities was retrieved. The average cost of medications and laboratory investigations was calculated. Statistical Analysis Tool Used: SPSS software version 16. RESULTS: The mean age of the patients was 58.44 ± 12.65 years. Of the 200 patients, 5 (2.5%) were on monotherapy and 195 (97.5%) were on combination therapy. One hundred and twenty (60%) patients had comorbidities which included congestive heart failure 55 (27.5%), diabetes mellitus 22 (11%), hyperlipidemia 15 (7.5%), and cardiovascular disease 13 (6.5%). The various classes of antihypertensive drugs prescribed were diuretics 128 (64.0%), beta-blockers 126 (63.0%), calcium channel blockers 106 (53.0%), angiotensin-converting enzymes inhibitors 103 (51.5%), angiotensin receptor blockers 33 (16.5%), alpha blockers 9 (4.5%), and fixed drug combinations 2 (1.0%). The average cost per month of the antihypertensive medications was ₦ 2045 (US$10.2). CONCLUSIONS: Antihypertensive prescription pattern was in accordance with the seventh report of Joint National Committee on Prevention, Detection, Evaluation, and Treatment of high blood pressure. Community-based insurance scheme should be encouraged and effective implementation of integrated noncommunicable diseases screening into the primary health care services would be helpful.

Evaluation of a health resources management course for Nigerian doctors.

AIMS AND OBJECTIVES: This study aimed to evaluate the March 2010 edition of the regular biannual two-week course on health resources management organised by the National Postgraduate Medical College of Nigeria. The main objectives were to assess participants' perception of the course and to measure change in their knowledge brought about by the course. SUBJECTS AND METHODS: This is a primarily cross-sectional study but with a before and after component. The study population comprised all participants who attended the course. Data were collected using pre-tested structured self- administered questionnaires. Data analysis was done with Epi Info 3.5.1. Student's T-test was used to compare mean scores at pre-test and post-test and the p-value of <0.05 was considered statistically significant. RESULTS: Majority (95.8%) of the participants were senior registrars from teaching hospitals and most of them (70.5%) claimed the course met their needs a great deal/to a large extent. The participants were satisfied to a varying degree with different aspects of the course but overall 50.9% claimed they got value for their money. There was a statistically significant difference in the knowledge score at pre- and post-test (t = 3.19, p = 0.002). CONCLUSION: The course met the needs of the participants largely and was able to improve their knowledge of health resources management as intended. A behaviour evaluation is recommended in order to assess the usefulness of the course to participants' practice.

Prevalence of cardiovascular risk factors amongst traders in an urban market in Lagos, Nigeria.

AIMS AND OBJECTIVES: A descriptive cross-sectional study was carried out to determine the prevalence of cardiovascular risk factors amongst traders in an urban market in Lagos State. SUBJECTS AND METHODS: Tejuosho market, one of the large popular markets was selected from a list of markets that met the inclusion criteria of being major markets dealing in general goods using a simple random sampling technique by balloting. Four hundred (400) traders were selected using a systematic random sampling. Each trader was interviewed with a well-structured questionnaire and had blood pressure and anthropometric measurements (height, weight and body mass index). RESULTS: Female traders made up (74.3%) 297 of the total population. The mean age was 45.48+11.88 and 42.29+10.96 years for males and females respectively. Majority 239 (59.8%) fell within the age range of 35 - 55 years. The cardiovascular risk factors identified and their prevalence rates were hypertension (34.8%), physical inactivity (92%), previously diagnosed diabetes mellitus (0.8%), risky alcohol consumption (1%), cigarette smoking (0.3%) in females and (17.5%) in males, obesity (12.3%) and overweight (39.9%). CONCLUSION: The study recommended that any health promoting, preventive or intervention programme for this population would have to be worked into their market activities if it is to make an impact.

Medical audit of diagnostic mammographic examination at the lagos university teaching hospital (luth), Nigeria.

PURPOSE: We studied the performance of diagnostic mammography in predicting malignancy among patients presenting with signs and symptoms of malignancy. MATERIALS AND METHODS: 310 patients who presented to the surgical out-patients of the Lagos University Teaching Hospital with signs and symptoms of breast cancer, between January 2002 and December 2003 had mammographic evaluation with a dedicated mammography unit. The mammographic appearances were prospectively classified using the BI-RADS assessment categorisation, and histological confirmation following surgical excision was correlated with mammography. RESULTS: The overall sensitivity of mammography in the study was 82.8% (CI 78.6 - 87%) while specificity, Positive predictive value (PPV) and accuracy were 90.7% (CI 87.5-93.9%), 69.97% (CI 46.6 - 74.8%), and 89% (CI 85.5-92.5%) respectively. Multivariate analysis showed that sensitivity and specificity generally declined as breast density increased. CONCLUSION: Diagnostic mammography is useful in characterising breast lesions. This study analyses the performance of mammography and shows that the resultant specificity is high, however it may have to be used in conjunction with needle biopsy to achieve improve sensitivity and avoid unnecessary benign surgical biopsies.

The Prevalence and Predictors of Cigarette Smoking among Secondary School Students in Nigeria.

OBJECTIVES: This study was carried out to determine the prevalence of smoking among secondary school students and identify factors that influence smoking amongst them. METHODS: This descriptive and explorative study was conducted among 1,183 secondary school students, selected by multistage sampling from each of the 6 geopolitical zones in Nigeria. Data was collected by using interviewer administered structured questionnaires. RESULTS: This study recorded a lifetime smoking prevalence of 26.4% and current smoking prevalence of 17.1% among secondary school students in Nigeria. Most (82%) of the students had seen warnings against smoking and most of them were aware that it is possible for cigarette smoking to damage body organs. Unfortunately, however, seeing such warnings had no significant effect on their decision to smoke or not. The students who smoke were introduced to smoking mainly by their friends (67.4 %), and the television (13.4%). Smoking habits of the respondents were influenced by parents' educational status (p<0.05), having friends who smoke (p<0.05) and living with a smoker (p<0.05). CONCLUSION: Over a quarter of secondary school students had ever smoked. Peer pressure was the main reason cited by respondents for initiating smoking. It is suggested that our smoking prevention programmes be reviewed and appropriate health education and smoking cessation programmes be developed and implemented in order to prevent and control smoking among Nigerian students.

Sexual behaviour and associated risk factors among adolescent/ young adult male transport workers at yaba bus stop, lagos.

OBJECTIVES: Sexual activity is increasing among young people with negative consequences and out of school males are a vulnerable segment of the population. This study was carried out to examine the sexual behaviour of young males who are out of school and identify factors that influence their behaviour. METHODS: This descriptive study was conducted among all the three hundred and ninety one young male bus conductors and drivers at Yaba bus stop Lagos. They were interviewed using a structured questionnaire. RESULTS: Almost all the respondents (93.4%) have had sexual intercourse and many of them with multiple partners. Less than half of them used condoms at every intercourse. Their main reasons for initiating sexual intercourse were peer pressure and curiosity. There was a significant relationship between early initiation of sexual intercourse and use of drugs and alcohol(p<0.05).Respondents who have resided with their parents initiated intercourse at an older age than those residing with other people.(p<0.05) CONCLUSION: Many young out of school males are sexually active and engage in high-risk sexual behaviour. Provision of sexuality education programmes, co-habitation of parents with their young children and the control of use of alcohol and drugs are important in delaying sexual initiation and reducing sexual risk taking among young people.

Prevalence of byssinosis and other respiratory problems among textile mill workers in Asaba, Nigeria.

OBJECTIVES: This study was conducted to determine the distribution and severity of byssinosis and other respiratory problems in the different operation sections in a textile mill industry in Asaba. PATIENTS AND METHODS: This is a cross-sectional and analytic study in which workers directly exposed to cotton dust are compared with those not directly exposed to cotton dust at one point in time. RESULTS: A total of 735 workers were interviewed and 437 workers had respiratory examinations carried out on them. Byssinosis was diagnosed in 8 out of 405 workers (prevalence of 1.98%) who were not directly exposed to cotton dust, and 21 out of 330 workers (prevalence of 6.36%) who were directly exposed to cotton dust. The difference was found to be statistically significant (chi2 =9.25; df=1; 0.01

Knowledge and perception of obstetric analgesia among prospective parturients at the Lagos University Teaching Hospital.

BACKGROUND: Natural labour is painful. Such pain has little value and is potentially harmful to the parturient and foetus. OBJECTIVE: To assess knowledge, perceptions and acceptance of obstetric analgesia among prospective parturients. The effect of age, educational status and parity on the above variables was evaluated. DESIGN AND SETTING: Prospective cross-sectional study between October 2002 and April 2003 at the Lagos University Teaching Hospital (LUTH). PATIENTS AND METHODS: Patients attending ante-natal clinics voluntarily responded to a structured questionnaire which enquired patient's age, educational status and parity; knowledge, perceptions and acceptance of obstetric analgesia. The association between the variables was determined with the Pearson's Chi square test. RESULT: Four hundred and fifty patients of varying educational levels were studied. Only 175 (38.9%) knew of obstetric analgesia. There was a significant association between educational status and knowledge of obstetric analgesia (p = 0.000). Two hundred and ninety four patients (65.3%) would accept analgesia during labour of which 179 (60.9%) would leave the choice to the doctor to give them the "best available". There was no association between age, educational status and parity with acceptance (p > 0.05). Reasons for rejection included labour being a 'natural process' in 15.1%, faith in divine intervention 6.0% and concerns about side effects 3.1%. CONCLUSION: This study has revealed a dearth of knowledge and gross misconception about obstetric analgesia. With proper education, many patients will accept some form of analgesia during labour. There is an urgent need to commence standard obstetric analgesia services in our tertiary hospitals.

Comparison of three subtypes of depression.

The objective of the study is to identify socio-demographic variables and clinical characteristics which distinguish between three subtypes of depression. In a prospective manner, 227 patients meeting ICD-10 criteria for depression were grouped into 3 subtypes--unipolar depression without psychosis, unipolar depression with psychosis and bipolar disorder depression. Using a structured questionnaire, socio-demographic and clinical variables obtained from the patients were compared in the 3 subtypes. Bipolar disorder patients were more likely to have first episode of illness before age 30 years. Psychotic depression patients were most likely to have positive family history of mental disorder and to have attempted suicide previously. Depressed females were less educated and more likely to be married. Early age at onset of depression requires more public awareness on recognition of depression particularly in the economically productive group. Further studies are required especially in community samples to further confirm these findings.

Noise-induced hearing loss among textile workers in Lagos metropolis.

A cross-sectional sample of 204 textile workers was selected randomly from all sections (including the non-production areas), and was initially screened to exclude subjects with pathological middle ear as well as those currently working in sections classified as non-noise but who had been exposed to excessive noise in the past. A total of 17 workers were thus excluded leaving 187 who were then assessed by means of air-conduction and bone-conduction audiograms obtained by the use of a manual (medicor-SA 3L), pure-tone audiometer. All audiometric tests were preceded by an otological examination to rule out the presence of any significant aural pathological conditions. The subjects were divided into 3 groups, based on the noise levels observed at their worksites using a Bruel and Kjaer type 2225 (integrating) sound level meter viz: the noise-exposed group (noise levels > 90 dBA); the less-noise-exposed group (noise levels 85-90 dBA); and the non-noise-exposed group (noise levels < 85 dBA). A comparative analysis of the data on hearing threshold levels of the 3 groups showed that the noise-exposed group had significantly (P < 0.05) elevated hearing threshold levels at all frequencies and in each age group, although the maximal threshold shifts were observed at the 4000 Hz frequency. Also, the hearing threshold levels for the noise-exposed group increased with the duration of noise exposure. The study clearly showed the deleterious effects of uncontrolled occupational noise exposure on unprotected workers. A very high prevalence rate of noise-induced hearing loss (79.8%) was recorded for the noise-exposed group. The less-noise-exposed group recorded a comparatively low figure of 11.3%. The weaving section alone recorded the highest prevalence rate of 84.5%, followed very closely by the spinning section with 71.0%. The lowest prevalence rate (2.9%) was recorded for the administrative staff.

Utilisation differentials in a rural Nigerian health centre.

The Ala-Idowa health centre was established in 1980 to serve the two contiguous communities of Ala and Idowa with population of 3960 and 6580 respectively. Situated reasonably between the two communities, there is adequate physical accessibility to the health centre from both sides. The population structure of the combined community was determined through a household survey involving 125 households selected systematically from the total of 2500 households. A comparison is presented between this structure and that of the population of attendees at the outpatient department of the Ala/Idowa health centre as recorded in the outpatient register with a view to discerning differentials in utilisation among different age groups. The data showed that those under the age of 15 years made more use of the health centre services than any other age group. Also, of the total of 958 patients for whom a diagnosis was recorded, 565 (56%) presented with an infection or infestation alone while another 4% presented with an infection together with another condition. Malaria accounted for 358 (63.4%) of all reported cases of infection/infestation. It is hoped that the findings of this study can be used to further target health centre services at the appropriate groups within the community as well as directed to those conditions, particularly communicable and preventable, that continue to exert great morbidity on the populations of developing communities.