Periodontal Diseases in Adult and Elderly Nigerians: A National Survey.

BACKGROUND: Periodontitis has been shown to have links with general health and increase the risk of complications of some systemic diseases now showing a rising prevalence with age. The rising proportion of the elderly globally, and a high prevalence of periodontal disease among older adults may significantly impact the need for oral health care services in the near future. This national survey was carried out to highlight the trend of periodontal diseases among adult and elderly Nigerians and make evidence-based recommendations for good management outcomes. MATERIALS AND METHODS: A national cross-sectional survey of periodontal diseases (using the CPITN Index) among adult (35-44-year-old) and elderly (65-74-year-old) Nigerians selected by multistage sampling method. RESULTS: Periodontal disease is prevalent among adults (96.5%) and elderly (97.6%) Nigerians, with the zonal prevalence approximating the national prevalence. Gingivitis is the prevalent periodontal disease type in these age groups, with a national prevalence of 86.8%, 67.6% respectively, and more in the South than the North for both adults (90.7%, 83%) and elderly (75.7%, 59.7%), respectively (p<0.005). Destructive Periodontitis prevalence in adult and elderly Nigerians is 9.5%, 29.9%, respectively (p<0.05), with the North being more affected than South for both adults (13.4%, 5.6%) and elderly (37%, 22.7%), respectively (p<0.05). There is also a significant rise in the occurrence of destructive periodontitis with age, nationally and in all the zones (p<0.05). CONCLUSION: There is a high prevalence of periodontal diseases in adult and elderly Nigerians. The outcome of the management of periodontal diseases in adults and the elderly is inter-dependent on best practices in both oral and general health care service provision.

CONTEXTE: La parodontite a été liée à la santé générale et à l'augmentation du risque de complications de certaines maladies systémiques, montrant maintenant une prévalence croissante avec l'âge. La proportion croissante de personnes âgées dans le monde et une prévalence élevée des maladies parodontales chez les personnes âgées pourraient avoir un impact significatif sur le besoin de services de santé bucco-dentaire dans un avenir proche. Cette enquête nationale a été réalisée pour mettre en évidence la tendance des maladies parodontales chez les adultes et les personnes âgées nigérianes et formuler des recommandations fondées sur des preuves pour de bons résultats en matière de gestion. MATÉRIEL ET MÉTHODES: Une enquête nationale transversale sur les maladies parodontales (utilisant l'indice CPITN) parmi les adultes (35-44 ans) et les personnes âgées (65-74 ans) nigérianes sélectionnées par méthode d'échantillonnage à plusieurs niveaux. RÉSULTATS: Les maladies parodontales sont prévalentes chez les adultes (96,5 %) et les personnes âgées (97,6 %) nigérianes, la prévalence zonale approchant la prévalence nationale. La gingivite est le type de maladie parodontale prédominant dans ces groupes d'âge, avec une prévalence nationale de 86,8 %, 67,6 % respectivement, et plus dans le Sud que dans le Nord pour les adultes (90,7 %, 83 %) et les personnes âgées (75,7 %, 59,7 %), respectivement (p<0,005). La prévalence de la parodontite destructrice chez les adultes et les personnes âgées nigérianes est de 9,5 %, 29,9 %, respectivement (p<0,05), le Nord étant plus touché que le Sud pour les adultes (13,4 %, 5,6 %) et les personnes âgées (37 %, 22,7 %), respectivement (p<0,05). On observe également une augmentation significative de l'occurrence de la parodontite destructive avec l'âge, nationalement et dans toutes les zones (p<0,05). CONCLUSION: Il existe une prévalence élevée des maladies parodontales chez les adultes et les personnes âgées nigérianes. Les résultats de la gestion des maladies parodontales chez les adultes et les personnes âgées dépendent des meilleures pratiques dans la prestation de services de santé bucco-dentaire et générale. MOTS CLÉS: Prévalence, Gingivite, Parodontite, Nationale, Enquête.

Periodontal Disease Awareness and Knowledge among Nigerian Primary School Teachers.

BACKGROUND: Teacher-led oral health education is equally effective in improving the oral health knowledge and oral hygiene status of adolescents as dentist-led and peer-led strategies. AIM: The aim was to determine periodontal disease awareness and knowledge among Nigerian primary school teachers. SUBJECTS AND METHODS: This cross-sectional study was conducted among primary school teachers in Edo State, Nigeria. A self-administered questionnaire which elicited information on demography, awareness of the periodontal disease and source of information, knowledge of etiology, and symptoms of the periodontal disease, was the data collection tool.. The test of association was done using either Chi-square or Fisher's exact statistics. P value was set at 0.05 for significance level. RESULTS: Out of 180 teachers recruited from seven public primary schools in Benin City, Edo State, Nigeria, 151 of them fully participated by filling the study questionnaires giving a 83.9% (151/180) response rate. The majority 74.2% (112/151) of the participants reported having heard of the periodontal disease and the leading source of information was television. A total of 29.8% (45/151) of participants considered periodontal disease as the main cause of tooth loss among adult Nigerian. Only 12.6% (19/151) of the participants knew dental plaque as soft debris on teeth and 29.1% (44/151) attested that plaque can cause periodontal disease. The majority of the participants were not aware of age 81.5% (123/151) and gender 96.7% (146/151) predisposition to periodontal disease. The perceived manifestations of the periodontal disease reported by were mainly gum bleeding 35.1% (53/151) and swollen gum 20.5% (31/151). A total of 70.2% (106/151) of the participants considered periodontal disease as a preventable disease and about half 49.0% (74/151) of the participants considered daily mouth cleaning as the best preventive method. The majority 95.4% (144/151) of the participants expressed interest in learning about the periodontal disease and the most preferred methods were workshops and lectures. CONCLUSION: A significant proportion of the participants heard about periodontal disease from nondental clinic sources. There existed a poor awareness of etiology, age and gender predispositions, manifestation, complications, and the preventable nature of periodontal disease among the participants. However, the majority of them indicated interest in learning about periodontal disease which should be utilized in optimizing their knowledge.

Herpes labialis among dental healthcare providers in Nigeria.

INTRODUCTION: The epidemiology of herpes labialis has been relatively neglected. The objective of this study was to determine the prevalence and risk factors of self-reported herpes labialis among Nigerian dental health providers. MATERIALS AND METHODS: This cross-sectional study of final year dental students and dentists undergoing postgraduate training at University of Benin Teaching Hospital, Benin City, Nigeria was conducted in June, 2014. The demographic information, lifetime and period (previous year) experience of the herpes labialis, perceived triggers and action taken during the last episode were obtained using a self-administered questionnaire. RESULTS: The annual prevalence of herpes labialis was 7.4% while the lifetime prevalence was 22.1%. The lifetime prevalence was significantly associated with marital status, professional status and family history of herpes labialis. However, in binary regression, it was only marital status and family history of herpes labialis that emerged as the determinants of this lifetime prevalence. The most common trigger factors reported by the participants for the last episode of herpes labialis were fever, malaria, fatigue and stress. The actions taken by participants for the last episode of herpes labialis were using drugs without prescription (14.3%), application of lubricant (23.8%), nothing (57.1%) and could not remember (4.8%). CONCLUSION: Data from this study revealed that one out of fourteen and one out of five every studied dental healthcare providers had experienced herpes labialis in the last 12 months and their lifetime respectively. The reduction of fever inducing infections, stress and fatigue which were major triggers will help decrease herpes labialis among this studied group.

The oral hygiene status of institution dwelling orphans in Benin City, Nigeria.

INTRODUCTION: Orphans like other vulnerable children face a number of challenges including limited or no access to basic health care including oral health care, which is one of their unmet health care needs. Neglected oral health care is associated with the development and progression of periodontal diseases among others. OBJECTIVE: To determine the oral hygiene status of institution dwelling orphans. MATERIALS AND METHODS: Thirty eight orphans from four orphanages in Benin City, Edo State of Nigeria were clinically examined and their oral hygiene status determined using the simplified oral hygiene index of Greene and Vermillion (OHI-S). RESULTS: Seventy-three percent of the orphans were found to have fair oral hygiene comprising mostly of those aged 6-13 years. More females were in this category while more males presented with poor oral hygiene status. CONCLUSION: More orphans presented with fair oral hygiene that indicated inadequate oral care. There was poor oral health education and limited access to services. There is need for these to be improved as a solution to poor oral health status of these vulnerable children.

The Oral Hygiene Status of Institution Dwelling Orphans in Benin City; Nigeria

Introduction: Orphans like other vulnerable children face a number of challenges including limited or no access to basic health care including oral health care; which is one of their unmet health care needs. Neglected oral health care is associated with the development and progression of periodontal diseases among others. Objective: To determine the oral hygiene status of institution dwelling orphans. Materials and Methods: Thirty eight orphans from four orphanages in Benin City; Edo State of Nigeria were clinically examined and their oral hygiene status determined using the simplified oral hygiene index of Greene and Vermillion (OHI-S). Results: Seventy-three percent of the orphans were found to have fair oral hygiene comprising mostly of those aged 6-13 years. More females were in this category while more males presented with poor oral hygiene status. Conclusion: More orphans presented with fair oral hygiene that indicated inadequate oral care. There was poor oral health education and limited access to services. There is need for these to be improved as a solution to poor oral health status of these vulnerable children

Prevalence of tobacco use among dental patients and their knowledge of its health effects.

OBJECTIVES: The objective of this study was to determine the prevalence of tobacco use in dental patients, to compare the knowledge of the effects of tobacco in tobacco users and nonuser, to determine their source of information, and to obtain their opinion on strategies that may be used to reduce or stop tobacco consumption. MATERIALS AND METHODS: A descriptive cross-sectional survey of 400 patients attending the University of Benin Teaching Hospital dental clinic for treatment was carried out using a self-administered questionnaire. RESULTS: The result revealed that the prevalence of tobacco use is 4.25% and that tobacco was consumed in the form of cigarette in 94% of cases. Only a small percentage of the respondents (0.3%) had a poor knowledge of both the tobacco effect on general and oral health. Although 26.5% claimed to have multiple source of information on the effect of tobacco on health but the media was the highest single source (23.5%). Banning of sales of tobacco products was suggested by 30.5% of the respondents, 19.8% suggested that doctor should educate patients on the health effect of tobacco, and 17.8% feel that to discourage tobacco use, multiple strategies should be used. CONCLUSION: There is a need for health workers to lay more emphasis on the rare complications of tobacco use. The use of multiple regulatory strategies should be employed to reduce the overall adverse health impact of tobacco and the media can play a great role.

Expectations and perceptions of Nigerian patients regarding infectious diseases in dentistry.

OBJECTIVE: To assess the expectations and perceptions of Nigerian patients regarding infectious diseases in dentistry. METHODS: A questionnaire based cross-sectional survey of patients attending the dental centre of University of Benin Teaching Hospital, Nigeria was conducted in 2009. RESULTS: Out of the 405 patients that responded, 75.6% expressed worry about contracting infection during the dental treatment. Respondents felt that they are at risk of contracting the following infection from the dental clinic, HIV (47.4%), hepatitis B and C (15.5%), herpes (3.5%) and tuberculosis (1.7%). One-quarter (25.4%) of the respondents would avoid dental treatment because of fear of contracting HIV. Ninety-two (22.7%) would switch from dental clinic with HIV infected personnel and 37.8% would allow HIV-infected dentist to treat them. Only 10.4% of the respondents would expect the dentist to refuse to render dental treatment to the HIV-infected patients. CONCLUSION: This survey revealed that a high proportion of Nigerian patients are worried about contracting infectious disease during dental treatment and this impacted negatively on how they seek dental care. Improved public education and communication on the risk involved with dental treatments is needed to allay the fear of Nigerian patients.

The use of the sisterhood method for estimating maternal mortality ratio in Lagos state, Nigeria.

Summary Estimates of maternal mortality are crucial to inform the planning of reproductive health programmes and guide advocacy. The aim of this study was to obtain a population-based estimate of maternal mortality in Lagos State, Nigeria. The sisterhood method was used in 2008 to carry out the survey using a questionnaire in which respondents were asked about their sisters who died during pregnancy, childbirth or within 6 weeks after childbirth. The survey involved 4,315 respondents who provided information on 9,910 ever married sisters. The life-time likelihood (risk) of maternal death for women aged 15-49 years was found to be 0.0239 or 1 in 42. The estimated maternal mortality ratio was 450 per 100,000 live births with a 95% CI of 360 and 530. Out of 111 reported deaths, 35 (31.5%) occurred during pregnancy, 49 (44.1%) occurred during delivery and 27 (24.3%) within 6 weeks of delivery.

A Study of Caesarean Section in a Secondary Health Care Facility in Uyo; South-South Nigeria

Background: The rising caesarean section (CS) rate in Nigeria has been reported by several studies. But while these studies were mainly conducted in tertiary health institutions; the experiences in the secondary health care facilities who are also actively involved in providing maternity care and caesarean delivery are rarely reported.Aim: To study the rates and indications for caesarean section in a secondary health facility in Uyo; Nigeria to provide alternate source of information on caesarean section. Methods: This was a five-year retrospective study of all cases of caesarean section in St Luke's hospital; Anua; Uyo; Nigeria covering the period of January 2000 to December 2004. Information on the socio-demographic characteristics of patients; number and types of CS and their indications were obtained from the delivery register; theatre register and other ward records. These were analyzed using simple percentages. Results: There were 10;190 deliveries in the period under review. Of these; 1384 were by caesarean sections giving a caesarean section rate of 13.6. The nullipara accounted for 36.6of cases of caesarean sections. There were similar rates of caesarean section among booked and unbooked patients. However; there were more emergency procedures among the unbooked patients.The major indication for caesarean section was fetal distress followed by repeat caesarean sections.Documentation and record keeping was a major challenge observed.Conclusion: Caesarean section rate observed in the study is lower than what obtains from most tertiary centres and falls within the recommended rates of 5-15

Haemoglobin genotypes: a prevalence study and implications for reproductive health in Uyo, Nigeria.

BACKGROUND: Haemoglobinopathies are among the most common genetic disorders worldwide, inherited as autosomal recessive disorders from healthy-carrier parents. The most common are the sickle cell disorders and the thalassaemias, occurring in people of African, Asian, South European and Middle Eastern descent. The University of Uyo Teaching hospital (UUTH), Uyo, Akwa Ibom state, Nigeria is a tertiary health institution providing the health needs of the host and neighbouring states in south-south and south east Nigeria. There is currently paucity of data on the hoemoglobin genotype distribution in Akwa Ibom State, hence the need for this study, considering its importance in medical diagnosis, parentent management, genetic information and counselling. METHODS: This is a retrospective study. Registers and results of all haemoglobin genotype investigations carried out in the department of Haemotology University of Uyo Teaching Hospital, Uyo between January, 2003 and December, 2007 were extracted, reviewed and analyzed using simple percentages. RESULTS: Eight thousand and ninety-seven haemoglobin genotype tests carried out over a five year period were analysed: 6376 (78.7%) of these were HbAA, 1580 (19.6%) HbAS, 121 (1.5%) HbSS, while HbAC and SC accounted for 16 (0.2%) and 4 (0.04% respectively. The ratios of Hb AA to Hb AS, HbAA to HbSS and HbAA to HbAC were 4:1, 52:1 and 400:1 respectively. Of the 8097 subjects, 6723 (83.0%) were females, 1152 (14.2%) were males. Among the females, 4.8% of HbSS and HbSc were in children under 15 years while only 0.3% were in those 15-44 years. CONCLUSION: While HbAA is the predominant genotYpe in our environment, there is also a significant number of the abnormal haemoglobin genes. With many children with sickle cell disease now surviving to adulthood due to advances in medicine, a larger number of women with sickle cell disease in pregnancy with all the attendant challenges it poses should be expected in our environment. It is necessary therefore, to keep abreast with developments in the area of its management in order to cope with the challenges.

Haemoglobin Genotypes: A Prevalence Study and Implications for Reproductive Health in Uyo; Nigeria

Background: Haemoglobinopathies are among the most common genetic disorders worldwide; inherited as autosomal recessive disorders from healthy-carrier parents. The most common are the sickle cell disorders and the thalassaemias; occurring in people of African; Asian; South European and Middle Eastern descent. The University of Uyo Teaching hospital (UUTH); Uyo; Akwa Ibom state; Nigeria is a tertiary health institution providing the health needs of the host and neighbouring states in South-south and South East Nigeria. There is currently paucity of data on the haemoglobin genotype distribution in Akwa Ibom state; hence the need for this study; considering its importance in medical diagnosis; patient management; genetic information and counselling. Methods: This is a retrospective study. Registers and results of all haemoglobin genotype investigations carried out in the department of Haematology; University of Uyo Teaching Hospital; Uyo between January; 2003 and December; 2007 were extracted; reviewed and analyzed using simple percentages. Results: Eight thousand and ninety seven Haemoglobin genotype tests carried out over a five year period were analysed: 6376 (78.7) of these were HbAA; 1580 (19.6) HbAS; 121 (1.5) HbSS; while HbAC and SC accounted for 16 (0.2) and (0.04) respectively. The ratios of Hb AA to Hb AS; HbAAto HbSS andHbAAtoHbAC were 4:1; 52:1 and 400:1 respectively. Of the 8097 subjects; 6723(83.0) were females; 1152(14.2) were males. Among the females; 4.8of HbSS and HbSc were in children under 15 years while only 0.3were in those 15 - 44 years. Conclusion: While HbAA is the predominant genotype in our environment; there is also a significant number of the abnormal haemoglobin genes. Withmany children with sickle cell disease now surviving to adulthood due to advances in medicine; a larger number of women with sickle cell disease in pregnancy with all the attendant challenges it poses should be expected in our environment. It is necessary therefore; to keep abreast with developments in the area of its management in order to cope with the challenges

Complications of unsafe abortion: case reports and the need for curriculum review in Nigeria.

Unsafe abortion remains a major reproductive health problem in Nigeria. These are 2 case reports of unsafe abortion, one performed by a patent medicine dealer where a false passage was created in the substance of the cervix to evacuate the uterus using a cannula. A piece of the cannula was left in situ for five years leading to chronic infection and infertility. The second case was performed by a medical practitioner for a second trimester abortion. He deliberately created a false passage in the substance of the cervix to evacuate the uterus leading to severe haemorrhage. We conclude that there is a need to review and improve the training of medical practitioners in termination of pregnancies to avoid unsafe abortion.

Heat resistance of dermatophyte's conidiospores from athletes kits stored in Nigerian University Sport's Center.

The incidence and heat resistance of conidiospores produced by dermatophytes isolated from athlete's kits (canvasses, stockings and spike shoes) stored in Nigerian University Sport's Centre were investigated. Epidermophyton floccosum, Microsporum oudouinii, Microsporum canis, Trichophyton concentricum, Trichophyton mentagrophytes and Trichophyton rubrum were isolated and their incidence on the athlete's kits varied with the species and type of kits. Among the isolates T. mentagrophytes, T. rubrum and E. floccosum with 25%, 23% and 20% prevalence rates respectively, were the most common isolates, and are often associated with tinea pedis (athletes foot). Canvasses with the highest incidence of dermatophytes (25 out of 34 fungal isolates) were the most contaminated kits and could serve as effective articles for the transmission of tinea pedis among athletes in Nigeria. The common etiological agents screened, produced asexual spores (conidiospores) that exhibited high resistance to heat treatment at 80 degrees C. Of the three isolates, E. floccosum, with a decimal reduction time (D-value) of D80 = 4.4 min was the most resistant followed by T. mentagrophytes with D80 = 4.0 min and then T. rubrum with D80 = 3.2 min. The spores elimination pattern indicates that increasing the heating duration would decrease the decimal reduction time and possibly denature the fungal propagules but may damage the skin during treatment with hot water compresses. The findings have shown that the use of hot water compresses is palliative but heat treatment especially vapour-heat treatment offers adequate preventive measures if applied for periodic treatment of contaminated kits. However, determining the correct condition for effective decontamination will require detailed understanding of the heat resistance of fungal spores. Otherwise treatment of kits with detergent and chaotropic agent such as urea and guanidinium salt is preferred to heat treatment.

Growth, keratinolytic proteinase activity and thermotolerance of dermatophytes associated with alopecia in Uyo, Nigeria.

Mycological research was conducted on the mycelial growth, keratinolytic proteinase activity and thermotolerance ofdermatophytes associated with alopecia patients in Uyo, Nigeria. The results revealed that Microsporum sp. - AP1, Epidermophyton sp. - AP2, Trichophyton rubrum - AP4, Trichophyton mentagrophytes - AP5 and a yeast Candida albicans - AP3 isolated exhibited variable growth and keratinase activity at different temperatures. Microsporum sp. - AP1 and T. mentagrophytes - AP5 survived heat treatment at 90 degrees C but exhibited best mycelial growth at 30 degrees C (with 53.41 mg/50 ml biomass dry weight) and 40 degrees C (with 61.32 mg/50 ml biomass dry weight) respectively, after incubation for 2 weeks. Trichophyton rubrum - AP4 and Epidermophyton sp. - AP2 could not survive heat treatment at 90 degrees C but grew better at 40 degrees C (with 38.52 mg/50 ml biomass dry weight) and 30 degrees C (with 48.32 mg/50 ml biomass dry weight) respectively, over the same incubation period, while C. albicans - AP3 grew better at 30 degrees C with 38.7 mg/50 ml biomass dry weight after 2 weeks, but failed to survive at 70 degrees C. All the isolates except Candida albicans - AP3 survived at 80 degrees C and exhibited great potential to elaborate keratinolytic enzymes, with T. mentagrophytes demonstrating the best potential at 30 degrees C and 40 degrees C. Higher temperatures tended to reduce keratinolytic activities and there were significant (P < 0.05) relationships between biomass weight and enzyme productivities of all the isolates except T. mentagrophytes. This indicates that in some dermatophytes keratinolytic proteinase activity is not a function of cell multiplicity. This plus the high thermostability of the enzymes are important attributes in the consideration of preventive and therapeutic methods against dermatophytes in the tropics.

Perceived oral Health Status and Treatment Needs of Dental Auxiliaries

Objective: To determine the perceived oral health status and treatment needs of Nigerian dental therapists in training and dental technology students. Methods: A descriptive cross-sectional study of students from Federal School of Dental Therapy and Technology Enugu; Nigeria was conducted using self-administered questionnaire to obtain information on demography; self-reported oral health status; knowledge of impact of oral health on daily life activity; dental attendance and perceived dental need. Results: The perception of oral health status and treatment need of the two groups of dental auxiliaries was the same. Fewer respondents (27.3) rated their oral health as excellent; while 50.4rated their oral health as good. Majority (95.5) agreed that oral health is a part of general health and 94.6agreed that oral health has a role in daily life. Out of 81.4that had previous dental treatment; scaling and polishing accounted for 66.1. Presently; 48.8think they need dental treatment ranging from scaling and polishing (33.9); tooth restoration (10.3); to extraction (1.2). Conclusion: This survey revealed that most of the students are aware that oral health is a component of general health and that it has an impact on an individual's daily life. More than half of the students perceived their oral health as good; but only a few knew that there is a need for a preventive approach to oral health as evident by the percentage that perceived scaling and polishing as a treatment need

Contraceptive prevalence among young women in Nigeria.

In almost all societies in the world there is an increase in sexual activity among young persons (10-24 years). There is a need for contraceptive use among them to prevent high risk unintended pregnancies. This study was carried out to determine the contraceptive prevalence among young women in Nigeria. The study population was 832 young women between the ages of 15 and 24 years. Only 11.1% of the respondents had ever used contraceptives although 63.2% of them had had sexual intercourse. Contraceptive usage was significantly higher (p<0.05) among the single sexually active women (38.5%) than among the married women (7.7%). Only 7.3% of respondents are currently using a contraceptive method. The main methods in use were condoms and pills. There is an unmet need for contraceptives among young women in Nigeria. It is necessary to improve these young women's abilities to protect themselves against unwanted pregnancies.

Induced abortion in Nigeria: findings from focus group discussion

Abortion is carried out daily in Nigeria despite the restrictive abortion law. This study was carried out to obtain information on societal attitude to the issues of family planning; unwanted pregnancy; abortion; adoption of children and laws relating to them. Focus group discussions were held in south-western Nigeria among 11 sub-groups. Participants felt that there was high prevalence of unwanted pregnancy and abortion particularly among youths. They had high level awareness of contraceptives and ascribed its low use to negative side effects; high cost and provider bias. Christians favoured planning of pregnancies while the Muslims did not. Majority of the respondents had negative perception of induced abortion. Some of them supported abortion if the education of the young girl would be disrupted; if paternity of pregnancy is in dispute; or if it would save the family from shame. Participants supported the enactment of laws that would make adoption of unwanted children easier.Abortion is carried out daily in Nigeria despite the restrictive abortion law. This study was carried out to obtain information on societal attitude to the issues of family planning; unwanted pregnancy; abortion; adoption of children and laws relating to them. Focus group discussions were held in south-western Nigeria among 11 sub-groups. Participants felt that there was high prevalence of unwanted pregnancy and abortion particularly among youths. They had high level awareness of contraceptives and ascribed its low use to negative side effects; high cost and provider bias. Christians favoured planning of pregnancies while the Muslims did not. Majority of the respondents had negative perception of induced abortion. Some of them supported abortion if the education of the young girl would be disrupted; if paternity of pregnancy is in dispute; or if it would save the family from shame. Participants supported the enactment of laws that would make adoption of unwanted children easier

Characteristics of Abortion Care Seekers in South-Western Nigeria

This prospective hospital-based study was carried out to understand the characteristics of abortion care seekers in south-western Nigeria. Information was obtained from a total of 1876 women seeking abortion at hospitals using a questionnaire. The results show that majority (60 ) were between the ages of 15 and 24 years; of which adolescents between the ages of 15 and 19 years constituted 23.7 . Most (63.2 ) of the respondents were unmarried; but married women also constituted a significant proportion (30.2 ) of the abortion care seekers. Students were the single highest group; while the predominant economic activity was trading (26.7 ). Respondents terminated their pregnancies mainly because they were students or because they did not desire to have children. Most (35.5 ) of the women were introduced to providers by friends. Average contraceptive prevalence among the abortion care seekers was 27.4 . It is obvious from the results that young persons; especially in-school adolescents; should be targeted for comprehensive sexuality education especially in view of the current HIV/AIDS pandemic

Training traditional birth attendants in Nigeria--the pictorial method.

High maternal mortality and morbidity rates are a challenge for all involved in the care of mothers and babies. One response takes the form of an educational programme led by professional midwives to teach traditional birth attendants to recognize risk conditions and improve their care of mothers and babies. Such a programme was organized as part of a Canadian-Nigerian safe motherhood initiative, and carried out in Akwa Ibom State, Nigeria.