Compendium of Oral Pathologies in Children Presenting to A Tertiary Hospital in Nigeria

Background: Oral diseases are one of the most common non-communicable diseases. They are also the most neglected particularly in children. Objective: To determine the pattern and trend of oral diseases among children who presented in the dental clinic of a Nigerian Tertiary hospital over 58 months. Methodology: A retrospective study that assessed for oral diseases among children using the dental health records. Results: 1104 cases presented at the dental clinic, comprising 546 males and 558 females with a ratio of 1:1.02. The mean age of the subjects was 10.6 years ± 4.2 with an age range of 1 month to 17 years. Close to ninety-eight percent of cases reviewed were symptomatic. Across all age groups, dental caries and its sequalae was observed in 62.2% of cases and this was independent of age group and year of presentation (p<0.0001). Conclusion: An increasing trend of oral diseases was observed annually with the leading diagnosis been dental caries and its sequalae

Sexual behavioral pattern, consequences and adopted solutions among senior secondary schools students in a military barracks in Nigeria.

PURPOSE: To determine the sexual behavioral pattern, consequences, and adopted solutions among senior secondary schools students in Ojo military barracks, Lagos. MATERIALS AND METHODS: This was a cross-sectional study of 400 senior secondary schools students in Ojo military barracks, Lagos, selected using a multistage sampling technique. Data was collected using pre-tested, self-administered semi-structured questionnaires. Data was analysed using statistical package for social sciences version 17. Tests of statistical significance were carried out using χ2-test, and a p-value of <0.05 was considered significant. RESULTS: The majority of them 391 (97.8%), were in the age group (10-19 years) while the mean age was 15±2.4 for males and 15±2.2 for females, respectively. One hundred and fifty four (38.5%) of the respondents have had penetrative sexual intercourse and were influenced mainly by peer pressure (p=0.0000). Their age at first sexual intercourse ranged between 10-19 years. Ten (6.5%) of the respondents (all males) had their sexual debut with a commercial sex worker. More girls 41 (56.2%) than boys 12 (14.8%), were forced into sexual intercourse (p=0.0000). Over half of the sexually active respondents had at least two sexual partners for either sex. CONCLUSION: Findings from this study have shown that young people living in the barracks indulged in sexual activity at very early ages and engaged in risky sexual behavior. We therefore recommend an improved multi-sectoral approach in reproductive health and sexually transmitted infections including HIV/AIDS education.

How do health workers perceive and practice monitoring and evaluation of malaria control interventions in South-east Nigeria?

BACKGROUND: The Anambra state Malaria Control Booster Project (ANMCBP) depends on an effective monitoring and evaluation (M&E) system to continuously improve the implementation of the malaria control interventions. However, it is not clear how the health workers that are expected to be the fulcrum of the malaria M&E perceive and practise M&E. The study was carried out to determine the knowledge, perception, and practice of Malaria M&E among selected health staff, and to identify related socio-demographic factors, including cadre of staff. METHODS: A semi-structured questionnaire and an observation checklist were used to collect information from selected health workers in public primary health centres in all 21 local government areas of the State. Multistage sampling technique was used in selection of respondents. The questionnaire explored knowledge, perception and practice of malaria M&E from 213 health workers. The observation checklist was used to record the actual practice of malaria M&E as observed by trained supervisors. RESULTS: Over 80% of health workers interviewed were able to correctly identify the malaria M&E forms; 25.4% knew the basis for categorizing Artemisinin-based combination therapy (ACT) into ACT1 - ACT4; 97.6% of the respondents felt there was need to keep proper records to have information available and 7.5% of them kept records because they were asked to do so. Over 90% of respondents reported correct practice of M&E, but on verification of actual practice, 55.6% of the respondents had at least one wrongly filled form, and half of these had none of their forms properly filled; about 68.4% of respondents had met specified timeline for data transmission. Differences observed in knowledge, perception and practice of M&E across age categories and cadres were only significant in ability to identify malaria M&E forms; diagnosis of malaria based on blood film microscopy result; perception of how age should be recorded; and reported practice of keeping data till they are requested. Among lower cadre of staff, gaps still exist in knowledge, perception and practice of malaria M&E. CONCLUSIONS: Gaps still exist in health workers' understanding of malaria data management, perception of efficient data transmission and observed practice of malaria M&E.

Becoming pregnant during secondary school: findings from concurrent mixed methods research in Anambra State, Nigeria.

OBJECTIVES: Pregnancies among teenagers and problems associated with premarital births have raised concerns in many countries. It is important to explore unintended pregnancy from the viewpoints of local stakeholders such as students, schools/teachers, and community members. This study assessed reported cases of unintended pregnancy among students and perceptions of these pregnancies by members of the community. METHODS: This study took place in a rural community in Anambra state, southeastern Nigeria. A cross-sectional survey of 1,234 students and 46 teachers in five secondary schools was carried out using self-administered questionnaires. In addition, focus group discussions (FGD) involving 10 parents and in-depth interview (IDI) with a student who became pregnant were conducted. RESULTS: Reports of pregnancy were more common during second and third years of junior secondary school than other school years or level. According to teachers, ignorance was the main reason given by students who became pregnant. Students who became pregnant were reported to have performed poorly academically and lived with both parents, who were either subsistence farmers or petty traders. In the IDI, the ex-student opined that pregnant students faced shame, marital limitations and lack of respect from community members. Participants in the FGD suggested that teenagers should be provided with sex education in schools and in churches; parents should communicate with teenagers about sexual matters and make adequate financial provision; and the male partners should be held more accountable for the pregnancies. CONCLUSION: Poor sexual knowledge and poor socioeconomic conditions play important roles in teenage pregnancy. Male participation may enhance effectiveness of prevention programmes.

Examining equity in access to long-lasting insecticide nets and artemisinin-based combination therapy in Anambra State, Nigeria.

BACKGROUND: In order to achieve universal health coverage, the government of Anambra State, southeast Nigeria has distributed free Long-lasting Insecticide treated Nets (LLINs) to the general population and delivered free Artemisinin-based Combination Therapy (ACT) to pregnant women and children less than 5 years. However, the levels of coverage with LLINS and ACTs is not clear, especially coverage of different socio-economic status (SES) population groups. This study was carried out to determine the level of coverage and access to LLINs and ACTs amongst different SES groups. METHODS: A questionnaire was used to collect data from randomly selected households in 19 local government areas of the State. Selected households had a pregnant woman and/or a child less than 5 years. The lot quality assurance sampling (LQAS) methodology was used in sampling. The questionnaire explored the availability and utilization of LLINs and ACTs from 2394 households. An asset-based SES index was used to examine the level of access of LLINS and ACTs to different SES quintiles. RESULTS: It was found that 80.5% of the households had an LLIN and 64.4% of the households stated that they actually used the nets the previous night. The findings showed that 42.3% of pregnant women who had fever within the past month received ACTs, while 37.5% of children<5 years old who had malaria in the past month had received ACTs. There was equity in ownership of nets for the range 1-5 nets per household. No significant SES difference was found in use of ACTs for treatment of malaria in children under five years old and in pregnant women. CONCLUSIONS: The free distribution of LLINs and ACTs increased household coverage of both malaria control interventions and bridged the equity gap in access to them among the most vulnerable groups.

Impact of timing of sex education on teenage pregnancy in Nigeria: cross-sectional survey of secondary school students.

The objective of this study was to explore whether the time at which sex education was provided had any impact on reported cases of unintended pregnancies. A cross-sectional survey of secondary school students and their teachers was conducted using self-administered questionnaires. The participants were 1,234 students aged 14-17 years and 46 teachers in 5 secondary schools in South Eastern Nigeria. The outcome measures were reported pregnancies within the last 3 years by type of school and class level; class level at the time of receiving sex education at school; and age at the time of receiving sex education at home. In all schools, sex education was provided at all the junior and senior secondary school levels (JSS and SSS, respectively). Overall, reported cases of unintended pregnancies were highest among the junior students. In the private schools, four in ten teachers reported pregnancies among JSS 3 students. Almost four in ten teachers in public schools reported pregnancies among JSS 2 students. Of all the students, about three in ten reported pregnancies among JSS 2 and 3 students respectively. At home, sex education was provided at the mean age of 16 years (SD ± 2.2). All participants cited financial need and marital promise as major predisposing factors. About four in ten students did not use contraceptives during their first sexual experience. This study highlights the need to introduce sex education much earlier, possibly before the JSS levels. At home, sex education may have greater impact if provided before the age of 14 years. Efforts should be made to address the factors predisposing to teenage pregnancy.

Unintended pregnancy and termination of studies among students in Anambra state, Nigeria: are secondary schools playing their part?

This study evaluated efforts of secondary schools to prevent unintended pregnancy among students and their reactions to pregnant students before and after delivery. A cross-sectional survey of 46 teachers in three public and two private schools in Anambra state, Nigeria was carried out. Information was collected using self-administered questionnaire. Of all the teachers in the study, 87% reported unintended pregnancies among students in the previous 3 years. Expulsion (43%) and suspension (28%) were the most common reactions. Private schools were more likely to expel pregnant students than public schools. Following the delivery of their babies, 43% discontinued their education in the same school, whereas 37% continued their education in a different school. Counselling was given before suspension or expulsion in 4% of public schools and 15% of private schools. Majority of the schools (61%) did not have sex education as part of their schools' curriculum. Students should be re-admitted in order to ensure continuity of their academic development, prevent unemployment and mitigate poverty-induced repeat pregnancy.

Intimate partner violence among women of childbearing age in a primary health care centre in Nigeria.

This study assessed the prevalence and characteristics of intimate partner violence among women of childbearing age in a primary health centre. With interviewer-administered questionnaire, information on partner violence was elicited from three hundred women of childbearing age selected by systematic sampling in a primary health care (PHC) centre. Over 40% had experienced violence within the last 12 months. Type of marriage and partner's education had effect on violence. Perceived reasons for violence were economic demand (56.1%), reproductive issues (42.5%), alcohol and drugs (61.2%). Forty eight per cent reported to family members. Only 1% reported to the Police. Intimate partner violence is a prevalent public health problem in eastern Nigeria. Health workers and social organisations should recognise the problem and offer necessary support, and women should be empowered to navigate through the problem.