Effect of Nursing Intervention on Mothers' Knowledge of Cervical Cancer and Acceptance of Human Papillomavirus Vaccination for their Adolescent Daughters in Abuja - Nigeria.

OBJECTIVE: The aim of this study is to evaluate the effect of nursing intervention on mothers' knowledge of cervical cancer and acceptance of human papillomavirus (HPV) vaccination for their adolescent daughters in Abuja, Nigeria. METHODS: This was a quasi-experimental study that utilized two groups pre and post-test design. The study was carried out among civil servant mothers in Bwari (experimental group [EG]) and Kwali (control group[CG]) Area Councils of Abuja, Nigeria. One hundred and forty-six women who met the inclusion criteria were purposively selected for this study. EG consists of 69 women while 77 are from CG. The intervention consisted of two days workshop on cervical cancer and HPV vaccination. Descriptive and inferential analyses of the data were performed using SPSS software 20 version. RESULTS: The mean age of the respondents was 35 years ± 6.6 in the EG and 41 years ± 8.2 in the CG. The mean knowledge score of cervical cancer was low at baseline in both EG (9.58 ± 7.1) and CG (11.61 ± 6.5). However, there was a significant increase to 21.45 ± 6.2 after the intervention in EG (P < 0.0001). The baseline acceptance of HPV vaccination was high in EG after intervention from 74% to 99%. Exposure to nursing intervention and acceptance of HPV vaccination was statistically significant after intervention (P < 0.0001). CONCLUSIONS: The nursing intervention has been found to increase mothers' knowledge of cervical cancer and acceptance of HPV vaccination. It is therefore recommended that nurses should use every available opportunity in mothers' clinic to educate on cervical cancer and HPV vaccination.

Feasibility of implementing a cellphone-based reminder/recall strategy to improve childhood routine immunization in a low-resource setting: a descriptive report.

BACKGROUND: Reminder/recall systems are effective ways to improve immunization rates, but their feasibility in primary health care (PHC) settings in Nigeria has not been adequately evaluated. In this study we describe the acceptability and adaptability of immunization reminder/recall system in an urban setting in southwest Nigeria. METHODS: This is a descriptive report of a cluster randomized controlled trial. Four local government areas (LGAs) were randomly assigned into a cellphone reminder/recall intervention group or a usual care control group. Within each LGA, PHC centers were purposively selected to participate in the study. In each PHC center, mothers and their infants aged 0-3 months were enrolled into the two groups during the infants' first immunization visit. Mothers (or other contact persons) in the intervention group received cellphone calls reminding them to take their child for scheduled immunizations. Follow-up of all the children lasted till the final scheduled immunization visit for each child. The intervention lasted for 13 months. RESULTS: A total of 595 mothers/infants pairs (295 in the intervention group and 300 in the control group) participated in the study. Almost all mothers (n = 590, 99.2%) had access to their own cellphone or had access to a cellphone belonging to a significant other. Ninety-eight percent (n = 584) of all mothers were willing to receive immunization reminder/recall phone calls. Eighty-seven percent (n = 2023) of all calls (n = 2324) for the reminder/recall intervention went through to the recipients and of these calls, 1948 (96.3%) were received. The mean cost of each call in US Dollars was about 5 cents. Immunization compliance rate (the receipt of required number of doses of routine vaccines at the appropriate age at recommended interval) was 79.2% among the children in intervention group and 46.4% in the control group (p < 0.001). CONCLUSION: Results demonstrate that cellphone reminder/recall interventions to improve routine childhood immunization are feasible in PHC settings in limited-resource settings with wide cellphone coverage, such as urban areas in Nigeria. Further research to test the potential for scale up in a variety of settings is recommended. TRIAL REGISTRATION: PACTR201702002043415 ; Date of registration: 17 February 2017. (Retrospectively registered).

Awareness, knowledge and practices of breast cancer screening measures among female postgraduate students of a Nigerian Federal University: a cross-sectional study.

INTRODUCTION: Annually, over a million new cases of breast cancer results in about 375,000 deaths worldwide. Recently, the burden of the disease has been on the increase in Nigeria and most cases present in hospitals late when cure becomes elusive. The choice of postgraduate students for this study was as a result of their potential to impact positively on the rest of the population by the virtue of their present or future positions. This forms the basis for this study. METHODS: This cross-sectional descriptive study recruited 278 female postgraduate students of the University of Ibadan, Nigeria as participants using purposive sampling technique. Data were collected with the aid of a validated structured questionnaire. The research protocol was approved by the UI/UCH Ethical Committee. Both descriptive and inferential statistics were used for data analysis with the aid of Statistical Package of Social Sciences (SPSS) version 16. RESULTS: The students' mean age was 27 years ± 5.1 Std. Most of the postgraduate students were aware of the breast self examination (BSE), clinical breast examination (CBE) and mammography through health workers. Out of 159 respondents that claimed to be practicing BSE, 118 (58.4%) used to practice it occasionally. Out of 53 postgraduate students that had CBE done, 7.4% had CBE done by nurse/midwives. Among the students 11.4% had good knowledge of BSE. Similarly, 33.7% had good knowledge of breast cancer risk factors. Besides, the higher the level of knowledge of breast cancer the more the possibility that postgraduate students will practice BSE (Chi-square = 15.169, df = 4, P-value = 0.004). CONCLUSION: It is suggested that health workers should reach students within the academic communities with effective breast cancer prevention campaign programmes. Besides, both printed and electronic media should be used for dissemination of health education/information to ensure wider coverage.

Assessment of women's risk factors for breast cancer and predictors of the practice of breast examination in two rural areas near Ibadan, Nigeria.

OBJECTIVE: In Nigeria, breast cancer is the most common cancer among women in majority of the regions. Late presentation has also been reported for about four decades. This study assessed the women's risk factors for breast cancer and predictive factors for the practice of breast examinations. The findings will be of help in enhancing early detection of the disease and reducing mortality from the disease. METHODS: Utilizing a multi-stage sampling method, 420 women were selected at Akinyele Local government area of Ibadan. Data was collected with questionnaire. The risk factor was evaluated using the breast cancer risk assessment tool based on the Gail model. Six demographic factors, plus four covariates: knowledge of BSE/CBE, knowledge of the cause of, symptoms and signs of and treatment of breast cancer, were regressed against two dependent variables of practice of BSE and CBE using linear regression and binary logistic analyses respectively. RESULTS: Only 386 questionnaires properly filled were analyzed. The mean age of respondents was 37.3 (SD=13.1) years. They were of low educational status and were mostly traders and married. Only 190 of the women fulfilled the criteria for assessment with the Gail model. Most of the women, 180 (94.7%), had five years and 184 (96.8%) had lifetime risks lower than that of the average woman of the same age. Four significant predictors of BSE were marital status (p=0.004), educational status (p=0.018), knowledge of treatment of breast cancer (p=0.029) and knowledge of BSE/CBE (p=0.0001) while no formal education status and being a farmer were the only significant predictors of CBE. CONCLUSIONS: The findings are useful for planning interventional studies to enhance early detection in a low resource country.

Rural women's perception of breast cancer and its early-detection measures in Ibadan, Nigeria.

Breast cancer is the leading cause of cancer death in women in many parts of the world and is the most common cancer in women in Nigeria. However, it lends itself to early detection and, subsequently, early treatment, if women use early-detection measures. It is pertinent to study rural women's perception of breast cancer and its early-detection measures because their perception would influence their use of early-detection measures of breast cancer. This is a descriptive study that assessed rural women's perception of breast cancer. Data from 2 rural health districts in Ibadan, Oyo state of Nigeria, were collected through a structured questionnaire. Four hundred seven women were randomly selected for the study. Results showed that 66.2% of the respondents considered that breast cancer is more severe than other forms of cancer. Respondents' perception of risk of developing breast cancer was low, as 64.8% rated themselves 1, on a scale of 1 to 9 (where 1 = does not perceive herself to have cancer; 9 = very much perceives herself to have cancer). Respondents' perceived cause of breast cancer included "putting money in brassiere" and attack from the enemy, among others. None of the respondents identified early detection as an advantage of breast self-examination. Swelling was the most acknowledged early-warning sign. Findings of this study indicate that there is a need for an interventional study to enhance the awareness of breast cancer and its early-detection measures among the rural population to influence early detection of breast cancer and subsequently reduce morbidity and mortality among them.

Knowledge of breast cancer and its early detection measures among rural women in Akinyele Local Government Area, Ibadan, Nigeria.

BACKGROUND: Breast cancer is the commonest cancer among women in Nigeria and globally. In Nigeria, late presentations of breast cancer cases have also been consistent for three decades. In an environment where there is no established national screening program for breast cancer, it is pertinent to assess the knowledge of breast cancer and its early detection measures. The objective of this study therefore, was to assess rural women's level of knowledge of breast cancer and its early detection measures. METHODS: The knowledge of various aspects of breast cancer; etiology, early warning signs, treatment modes and early detection measures; was assessed among women in two randomly selected health districts in Akinyele Local Government in Ibadan. The assessment was performed with the use of a self-structured validated questionnaire administered by trained interviewers to 420 women randomly selected from the two health districts. The various aspects of facts about breast cancer were scored and added together to determine respondents' level of knowledge RESULTS: The mean score of knowledge of breast cancer was 55.4 SD 5.4 (range of scores obtainable was 26-78), while the mean score for knowledge of early detection of breast cancer was 24.8 SD 2.3 (range of scores obtainable was 12-36). The leading source of information about breast cancer was "elders, neighbors and friends" and 63(15.4%) acknowledged this source, while only 18 (4.4%) respondents acknowledged health workers as source. Only 54 (13.3%) claimed to have heard about breast self- examination (BSE) however, and the leading source of information about BSE were health workers. Nine (2.2%) of respondents claimed this source. CONCLUSION: This study revealed that respondents lacked knowledge of vital issues about breast cancer and early detection measures. It also revealed that health workers were not forthcoming with information to the public thereby constituting a challenge to community health nurses and other health workers, to provide vital information to the public.