Parental Verbal Communication and Sexual Knowledge of Senior Secondary School Students in South East, Nigeria.

BACKGROUND: Parental verbal communication may influence the sexual knowledge of senior secondary school students in Enugu State, Nigeria. METHODS: This study utilized a school based cross-sectional study design and was conducted across the six education zones of Enugu State using three-stage sampling technique. A total of 400 respondents completed the interviewer administered questionnaires on their socio-demographics, sexual knowledge and parents' information on verbal communication skills. Obtainable knowledge scores for sexuality ranged between 0-10; scores of 1-5 were classified as poor and 6-10 as good. Data analysis for the quantitative data was done using IBM SPSS; version 22. Chi square test of statistical significance and multivariate analysis using binary logistic regression were used in the analysis, and the level of significance was set at a p value of less than 0.05. RESULTS: Out of the 400 respondents, 55.5% were girls. The mean age (SD) of the respondents was 15.9 ± 1.3 years. Although 15.5% and 8.8% of the respondents were very comfortable discussing sexually related matters with their mothers and fathers only 34.8% and 16.0% of mothers and fathers were comfortable discussing such matters with the respondents. Less than half of the respondents (42.5%) had good sexual knowledge. Verbal sexual communication between parents and respondents and age above 16 years were found to be predictors of good sexual knowledge. CONCLUSIONS: Poor parental verbal communication led to the poor knowledge of sexuality among the respondents. Parents should be encouraged to discuss sexuality matters with their children.

Clients' knowledge, perception and satisfaction with quality of maternal health care services at the primary health care level in Nnewi, Nigeria.

BACKGROUND: Clients' knowledge, perception of and satisfaction with the quality of maternal health services (QMHS) enables maternal health programs to assess the impact of their services from the clients' perspective. OBJECTIVE: The objective of this study is to assess the knowledge, perception of and clients' satisfaction with the QMHS at the primary health care (PHC) level in Nnewi, Nigeria. MATERIALS AND METHODS: This was a cross-sectional survey. Using multistage sampling technique, 280 women utilizing maternal health services from randomly selected PHC facilities in Nnewi, Nigeria were selected for the study. Data were collected using a mix of quantitative and qualitative methods. Quantitative data were analyzed using Statistical Package for Social Sciences version 16, while qualitative data were reported verbatim, analyzed thematically and necessary quotes presented. RESULTS: A total of 280 women were studied. The mean age of the respondents was 29.2 ± 5.9 years. 231 (82.5%) were married. 89 (31.8%) did not report any knowledge about QMHS. Level of satisfaction was not different among women of different socioeconomic groups ( P > 0.05). Sociodemographic characteristics of clients were not found to be associated to the perception of waiting time: ( P > 0.05). The attitude of health care providers toward the clients was reported as good. CONCLUSIONS: Despite the poor quality of services provided, this study showed that client's knowledge of quality of services was good. Furthermore cost, local language used, staff attitude and interaction with clients was acceptable and may be the reason for high level of satisfaction reported.

Effect of government-community healthcare co-financing on maternal and child healthcare in Nigeria.

BACKGROUND: Effective maternal and child healthcare delivery requires a proper and adequate funding of the health sector. OBJECTIVE: To determine the effect of government-community healthcare co-financing on maternal and child healthcare services' delivery. METHODS: A descriptive, cross-sectional study with an intervention component, conducted amongst 240 women from Igboukwu (intervention area), and Ekwuluobia (control area), of Anambra State of Nigeria. RESULTS: The biosocial characteristics of the respondents were essentially similar. Better utilization of health services occurred in the intervention area post-intervention. Quality of service from intervention clients' perspective showed significant improvement post-intervention. Distance less than five km, transportation cost less than N40, and maternal education above secondary level impacted positively on utilization of maternal and child health services. Acceptability of the scheme was better for the intervention facility evident from the higher number of respondents showing "willingness to join", and "willingness to pay". CONCLUSION: Health sector funding partnership, positively impacts on maternal and child health services. Government's total commitment, backed with legislation, and community mobilization, will sustain the scheme.

Radiological features of pulmonary tuberculosis in HIV-positive and HIV-negative adult patients in south-eastern Nigeria

Pulmonary tuberculosis (PTB) is the most common clinical presentation of tuberculosis. This study was carried out to appraise the radiological features of PTB in adult HIV-positive and HIV-negative pa-tients. The chest radiographs of the patients were evaluated in the tuberculosis, leprosy, and endemic disease (TBL) clinic, Ebonyi State University Teach-ing Hospital (EBSUTH), Abakaliki, south-eastern Nigeria, from April 2004 to June 2006. Of the total of 117 individuals studied, 68 (58.1) were males and 49 (41.8%) females, indicating a male preponderance of 1.4:1. Up to 49.6% of the subjects had PTB/HIV co-infection. The highest prevalence of PTB/HIV co-infection was recorded among males aged 31­40 (12.8%), and females aged 21­30 (11.1%). The com-monest radiological features observed were cavitory lesions (64.1%), patchy opacities (44.4%), and hilar opacities (38.5%). Bilateral cavitory lesions, patchy opacities and hilar opacities were more prominent than the right-sided or left-sided ones and appeared more frequently among individuals with PTB/HIV co-infection. Perihilar patchy opacities, consolidation and pleural effusion were seen in 19.6%, 6.0%, and 4.3% of all cases, respectively. There was no statisti-cally significant difference in the association between the radiological features and patient category (χ2 = 17.74, df = 18, p = 0.47). The chest radiography re-mains an important tool in the diagnosis of PTB and will continue to provide essential information for the management and follow-up of patients

Incidence of pelvic organ prolapse in Nigerian women.

OBJECTIVE: To establish the incidence and types of utero-vaginal prolapse. METHODS: Retrospective medical records analyses of women who were subjected to reconstructive pelvic surgery for various types of pelvic relaxation at the Nnamdi Azikiwe University Teaching Hospital, Nnewi and the University Of Nigeria Teaching Hospital, Enugu, Nigeria was carried out. The study was conducted from January 1996 to December 1999 during which there were 7515 surgical admissions. The inclusion criteria were those women who complained of feeling a mass in the vagina with demonAstrable descent of the anterior and/or posterior and/or apical vaginal walls and/or perineal descent. Excluded were patients who had other symptoms other than utero-vaginal prolapse and those whose grades and sites of prolapse were not determinable from the clinical or surgical notes. Also excluded were patients with nerve injury or disease, connective tissue disorders and neuromuscular diseases. The subjects were divided into two groups. Group I consisted of 54 women (age < or = 40 years), and group II included 105 women (age > or = 40 years). The findings between those two groups were compared with reference to sites, types and degree of prolapse. Also, coexistence of pelvic relaxation and underlying medical conditions were evaluated. RESULTS: A total of 159 subjects out of 492 charts studied met the inclusion criteria for the study. In group I, mean age was 32.839 with a standard deviation (SD) of +/- 6.012 years; and in group II the mean age was 56.543 with a SD of 8.094. Hypertrophic (elongated) cervix was determined in 15 (6.3%) subjects in group I for an incidence of 1.58% per year, cystocele (vaginal anterior wall descent) was present in 21 (8.9%) women for an incidence of 2.2% per year; rectocele (posterior vaginal wall descent) was identified in 15 (6.3%) women for an incidence of 1.58% per year; vaginal cough prolapse (apical descent) was present 21 (8.9%) women for an incidence of 2.2% per year. Perineal descent was absent in this group. In group II, there was no hypertrophic cervix; cystocele was present in 39 (16.5%) cases for an incidence of 4.13% per year; rectocele was identified in 27 (11.4%) women, amounting to an incidence of 2.85% per year; vaginal cough prolapse was present in 36 (15.%) women, an incidence of 3.75% per year; perineal descent was present in 63 (25.6%) women, for an incidence of 6.4% per year. CONCLUSION: (1) The incidence of hypertrophic cervix without any other abnormality amounted to 1.58% per year. This medical entity can present as uterine prolapse and was noted only in group I. (2) The annual incidence for hospital admission with a diagnosis of uterine prolapse was 2.1%. (3) The incidence of cystocele, and rectocele was not statistically different in the two groups; but the incidence of perineal descent and uterine prolapse were significantly more in group II than group I. (4) The etiology of hypertrophic cervix is not known, but it is of importance especially in the childbearing age when it may be related to prolonged pregnancy, cervical dystocia, etc.

Personal hygiene practice and school-based health education of children in Anambra State, Nigeria.

This study assessed the effect of school-based health education on the practice of personal hygiene by children in primary schools in Anambra State, Nigeria. Three hundred and ninety-five (395) and three hundred and ninety-eight (398) primary school pupils randomly recruited as intervention and control groups were rated on five key personal hygiene practices before, immediately after and three months after school-based hygiene health education. Less than 45% were rated clean before health education in both groups. Immediately after health education, more than 65% in the intervention group were rated clean. There was no change in the control group. The difference was statistically significant. However, there was a statistically insignificant decline in those rated clean three months after cessation of health education. The school-based health education improved the personal hygiene practice of the pupils. There is a need for regular reinforcement to sustain the gains.

Anal incontinence among Igbo (Nigerian) women.

Anal incontinence in patients who present to the gynaecology clinic for symptoms other than pelvic organ prolapse dysfunction is fairly common. A structured pre-tested 41-item pelvic organ prolapse questionnaire was administered by doctors to 3963 gynaecological patients, recruited from three states of south-eastern Nigeria, who were in the clinic for reasons other than pelvic organ prolapse dysfunction. This report considers only anal incontinence. We found a prevalence of 6.96% for anal incontinence. Of these, 2.67% were incontinent for liquid stool, 2.17% for solid stool and 2.12% for flatus. There appears to be a higher frequency of flatus incontinence in the reproductive years: 36.6% of primiparas aged <30 years had faecal incontinence. Flatus incontinence was present in 28 (43.7%) of 198 para 4 and below, and in 36 (56.3%) of 78 para 5 and above. There was thus a significant association between flatus incontinence and parity (chi2=32.4; p<0.001). Spontaneous vaginal delivery had a significant effect on anal incontinence (p=0.04). Physicians should, be able to detect this embarrassing condition and be alert to factors that may avert or ameliorate it.

Sources of sexual information and its relevance to sexual behaviour in Nigeria.

A study was carried out to identify the various sources of sexual information by adolescents in Nigeria and their influence on the sexual behaviours of the subjects, using: a) coitus prior to marriage b) expectation with first coitus c) freeness to discuss with spouse or anybody as parameters. The study was carried between 1997 and 1998 using subjects randomly selected from three Nigerian communities, viz: Enugu, Benin and Nnewi. Coitus before marriage was significantly higher in those who got their first ever information from peers than those who got it from other sources (P < 0.01). Fulfillment of expectation with first coitus was also significantly higher among those who were taught by parents, peers and teachers than those who sought their information on their own from books, magazines and films (p < 0.05). However, in considering their ability to discuss with anybody, this was found to be significantly higher in those who sought information on their own than those who got their first information by personal contact with parents, peers and teachers (p < 0.05). The latter was found to be more inhibited from discussing sexuality with their spouse or anybody than those who got their information from books/magazines and films. Sex education of adolescents should, therefore, be provided in a cultural, community-based setting of which the guardian programme should be only one component. It may be counter-productive in Nigeria if the adolescents continue to learn about sexuality on their own from books, magazines and films.

Communication and sexuality in a Nigerian community.

The traditional lack of interest in discussing sexuality creates a problem in doctor-patient communication, and this can affect patient management adversely. The dearth, ease or comfort in discussing sex was examined by a self-administered questionnaire to respondents, mainly medical students, nurses and paramedics, 20-70 years of age, who were not seeking treatment for sexual problems. The respondents were mainly of Igbo extraction from Eastern Nigeria. Factors considered include age, sex, religion, marital status, and education. The results show that 71.9% of all the respondents indicated that they would like to be able to discuss freely whereas 28.1% never really bothered; 40.9% of all the respondents could discuss sex with anybody whereas 59.1% could not; 75% in the married group discussed sex freely with their spouses or friends and 25% were unable to do so. Education showed a very significant influence on the ability to discuss sex freely. It is suggested that a systematic approach to education, especially sexual health education, may be a major way to combat the prevailing cultural inhibition.

Family planning knowledge, attitude and practice amongst males in a Nigerian urban population.

A study to investigate men's knowledge, attitude and practice of family planning was carried out in Enugu, South-eastern Nigeria between September and December 1996. A total of 380 adult working males were studied. A high proportion of the respondents had knowledge of and possessed positive attitude to family planning, even though a lesser proportion actually used family planning methods. Ninety per cent of the respondents accepted the decision that the number of children in the family should be made by the couple. While over 32 per cent of the men believed that the wife alone should use family planning methods, only 10 per cent thought it was the husband's role to use family planning methods. There is need for the present integrated national MCH/family planning programmes to be adapted for use by men.

Implications of seasonal variations in aflatoxin B1 levels in Nigerian market foods.

Aflatoxin B1 levels were determined in Nigerian rural and urban market foods from 1977 to 1978. In general, levels were found to be highest during the peak rainy season, and the data suggest that livestock and humans are at highest risk from aflatoxicosis during this time. The incubation period for humans and nonhumans varies, and the risk to man from seasonal exposure to aflatoxin is assessed and reviewed. Primary hepatocellular carcinoma patients showed first symptoms of tumors during the dry season.