Knowledge, awareness and perception of sexually transmitted diseases (STDs) among Nigerian adolescent girls.

Knowledge, awareness and perception of STDs among 983 adolescent female high school students at Onitsha, Nigeria is analysed. There was good general awareness of the common STDs, HIV/AIDS: 93.6% (n=920), gonorrhoea: 76.3% (n=750); syphilis: 69.1% (n=679), while the least was chlamydial disease: 6.6% (n=65). Knowledge of causes of STDs was high. Viruses were identified as the most common cause of STDs by 75.3% (n=740) of the respondents, followed by bacteria by 64.1% (n=630), while 17.8% (n=175) of the students believed that poison/witchcraft caused STDs. Surprisingly, 35.5% (n=349) identified herbs and natural medicines as effective remedies for these STDs; 56.7% (n=557) identified antibiotics as treatment for STDs, 33.8% (n=331) antiviral drugs, while a high percentage of the students believed in prayer houses as a remedy: 30.3% (n=298). The most common source of information was through the school: 80.6% (n=792), followed by television: 80.1% (n=787); radio accounted for 73.1% (n=719) and health workers for 64.1% (n=630). Awareness about preventive measures was as follows: abstinence 67.4% (n=663), mutual fidelity 56.7% (n=557) and condoms 54.8% (n=539).

Knowledge, awareness and perception of sexually transmitted diseases (STDs) among antenatal patients at Nnewi, Nigeria.

This study investigates STD knowledge, awareness and perception among antenatal patients at a Nigerian teaching hospital. There was general awareness of the common STDs, such as gonorrhoea, 95.5% (n=127) and syphilis 66.92% (n=89), while the least awareness was recorded in chlamydial diseases, 6% (n=8). HIV/AIDS recorded the highest awareness, 96.2% (n=128). There knowledge of causes and treatment was remarkably poor. Only 58.6% (n=78) could recognise bacteria as causing STD. Surprisingly more than half, 72.2% (n=96) still believed that remedy could be obtained from prayer houses, herbs and other non-scientific means. The most common source of information was through media houses: radio 72.9% (n=97), television 64.7% (n=86). Preventive awareness was high, more than half believing that STD is preventable either by abstinence, barrier contraception or by mutual fidelity. Superstitious beliefs, greater influence of traditional medical practices and poverty are some of the numerous problems the few existing STD clinics face in the developing countries. Efforts should be geared towards establishing standard STD clinics and appropriate information disseminating organs. A situation where the herbalists and traditional medical personnel capture the mostly ignorant populace through unrestricted access to the media houses, as currently practiced in Nigeria, should be checked.

Pattern of morbidity and mortality following illegal termination of pregnancy at Nnewi, Nigeria.

Seventeen women were treated for complications of illegal termination of pregnancy over a 2-year period, January 1996 to December 1997. Important characteristics of the women include a mean age of 21 years (mode 18 years) and being unmarried (100%, n=17), nulliparous (94%, n=16) and unemployed (76%, n=13). There was a tendency towards late termination as 50% of women had a termination after 13 weeks. Serious complications were cervical laceration, pelvic abscess/peritonitis, ruptured uterus, transection of the sigmoid colon and ileal/jejunal lacerations. The mortality rate was 6% (n=1). Most of the terminations were performed through instrumental cervical dilatation without prior medical or hydrophilic treatment. This study shows that illegal abortions are still commonly performed in Nigeria with an unacceptably high incidence of morbidity and mortality. Modernisation of abortion laws, wider contraceptive usage, adoption of modern methods of termination of pregnancy (RU 486 and prostaglandin E(1) analogues) and prophylactic antibiotics are recommended in order to reduce the problems of unsafe abortion in Nigeria and other developing countries.

Features of uterine fibroids treated by abdominal myomectomy at Nnewi, Nigeria.

Seventy-two women with symptomatic uterine fibroids were treated by abdominal myomectomy from January 1994 to December 1996. Important features were a mean age of 32.3 years (range 25-49 years) and parity of 0 to 6; 83% ( n = 60) were nulliparous and 68% ( n = 49) were unmarried. The average estimated blood loss was 480 ml with 1.6 g/dl mean haemoglobin drop and 15.3% required blood transfusion. Complications were mild and infrequent; 7% ( n = 5) had mild wound infection and 16.7% ( n 12) had a febrile complication. The average hospital stay was 8.1 days. There was no mortality. In this study, symptomatic uterine fibroids requiring abdominal myomectomy predominantly affected young women who were mainly unmarried and nulliparous. Although the the operation was safe and well tolerated, preoperative GnRH(a) is recommended to reduce fibroid size and need for blood transfusion.