Reference equations for spirometric indices from a sample of the general adult population in Nigeria.

BACKGROUND: The increasing importance of pulmonary function testing in diagnosing and managing lung diseases and assessing improvement has necessitated the need for locally derived reference equations from a sample of the general Nigerian population. METHODS: It was a cross sectional study in which we used linear regression models to obtain equations for reference values and lower limits of normal for spirometric indices in adult Nigerians from a sample of the general population aged 18-65 years (males) and 18-63 years (females). RESULTS: Seven hundred and twenty participants made up of 358 males and 362 females who satisfactorily completed the spirometric measurements using the ATS/ERS reproducibility and acceptability criteria were included in the analysis. The most important predictive variables were height and age. The values of the spirometic indices increase with increasing stature but decrease with increasing age in both sexes. The sex difference in all the indices is also apparent as all the indices, except FEV1/FVC, are higher in men than in women. Our values are higher than values obtained from previous studies in Nigeria (except FEV1/FVC) but the differences were not statistically significant. This suggests that although the values are increasing, the increase is yet to be significantly different from values obtained using the past equations. The implication of this is that there is need for periodic study to derive new equations so as to recognise when there is significant difference. There was no significant difference between values from our equations and those obtained from study among Ethiopians. Compared to report from Iran, our FVC and FEV1values (in males and females) as well as PEFR (in females) are significantly lower. Our values are also lower than values from Poland. We also observed disparities between our values and those of Afro Americans from the GLI study. CONCLUSIONS: Our findings show that it is important to always interpret ventilatory function tests in any individual by comparing it with reference values obtained from a well-defined population of healthy subjects of the same ethnic origin in similar geographic location.

An assessment of essential maternal health services in Kwara State, Nigeria.

The objective of this study is to evaluate the levels of emergency obstetrics care (EOC) signal functions in health facilities in a developing setting with high maternal morbidity and mortality indices and to determine if there are differences between public and private health facilities in terms of availability of these signal functions. A survey of health facilities was carried out in six of the 16 Local Government Areas (LGAs) of Kwara State Nigeria. All health facilities in these LGAs including public and private health facilities offering some services to pregnant women were surveyed using an interviewer- administered, facility-assessment questionnaire adapted from the WHO/UNFPA/UNICEF international guidelines for monitoring the availability and use of obstetric services. Frequency tables, percentages and charts were used for presenting the data. Comparing public and private facilities was done using chi-square tests. A total of 258 health facilities that provide maternal health services were surveyed in this study, out of which 76 (29.5%) were private facilities and 182 (70.5%) were public sector facilities. Most of the UN indicators were not met by the health facilities in Kwara state. The availability of EOC facilities was more among the private sector and this was statistically significant. This study shows that all stakeholders involved in reducing maternal mortality have a big challenge in the areas of availability, inequity in geographical distribution of EOC facilities and poor utilisation of these EOC services by women.

Behavioral Pattern of Menopausal Nigeria Women

Context : Menopause is one area that has been shrouded in myths and taboos and the way women perceive menopause depends largely on the social belief about menopause in their society. Objective : The aims of this study are to assess how women perceived the physical changes during menopause; what the social as well as the individual adjustment practice to menopausal changes might be. Materials and Methods : Qualitative focal group study among women aged 40 years and above where eight to ten volunteers formed a group. Six sessions were held for different focal group; each lasting 1-2 h. A tape recorder and a notepad were used to record the discussions. Opinions of the women were sought on socio-cultural differences in the perception of aging; perception of menstruation; perceived causes and consequences of menopause; sexual intercourse after menopause; social support networks for menopausal women; and types of care and treatment for women in menopause. Results: The participants in the FGDs used various phrases to describe menopause in local term; while some of the participants attributed disease to be a cause of menopause; others believed that it be could be caused by witchcraft or sorcery. However; younger and old women whose menstrual flow stops prematurely seek assistance; often from traditional or spiritual healers. Conclusion: This study reveals the poor menopausal knowledge among the study group with more than half of the respondents having negative attitude towards menopause in addition to mixed feelings about religious obligation and cohabitation

Amulets, Bands and Other Traditional Applications seen among Emergency and Neonatal Pediatric Admissions in a Tertiary Centre, Nigeria.

OBJECTIVES: This study aims to investigate the types and indications of amulets, bands and traditional applications among pediatric emergencies and neonatal admissions into the Federal Medical Centre, Bida, Nigeria. METHODS: This was a cross-sectional study conducted between January and July, 2008. Children admitted into the emergency and neonatal units of the institution with traditional applications were recruited. Information on demography, time the application was introduced, the reason, cost implication and belief about the efficacy were obtained using a semi-structured questionnaire. Socio-Economic Class was defined using the Oyedeji Classification. RESULTS: The study was based at Federal Medical Centre, Bida and consisted of 666 children admitted into the hospital via the Emergency pediatric and the Neonatal Unit, with a seven-month period prevalence of 11.4% (76 patients). Of the 76 cases screened for the use traditional applications, only 64 (84.2%) were recruited, the remaining did not agree to participate in the study. The mean age was 493.1±528.5 days. The study group included 37 males and 27 females (sex ratio 1.4:1) aged 11 days to 2920 days. The applications used included neck band (54.7%), ankle band (15.6%) and head paste (15.6%). Reasons for the applications included prevention of childhood illnesses (17.2%), sutures closure (15.6%), as well as warding off evil spirits and convulsions (12.5%). The socio-economic classification was I (1.6%), II (7.8%), III (15.6%), IV (45.3%), and V (29.7%). Sixty (93.0%) parents believed the applications cannot be used with conventional medicine, while 53.1% of the participants, obtained them free of charge. CONCLUSION: The use of traditional applications, often for preventive purposes, is common among pediatric patients, especially of low socio-economic classifications. The majority of users considered them incompatible with simultaneous conventional medical care. This has adverse implications for time to presentation for conventional care and treatment outcomes. Promotive and preventive healthcare interventions are needed to reverse this trend. Future broad-based research is warranted.