Adverse childhood experiences and psychological distress among higher education students in Southeast Nigeria: an institutional-based cross-sectional study.

BACKGROUND: Exposure to adverse childhood experiences (ACEs) constitutes public health problems linked to adverse mental outcomes such as psychological distress during adulthood. This study examines the prevalence of ACEs and psychological distress and explores the association between ACEs and psychological distress and demographic factors among young adults. METHODS: We conducted a cross-sectional study of 330 students from May 2018 to July 2018. The participants completed the Adverse Childhood Experiences International Questionnaire (ACE-IQ), Kessler Psychological Distress Scale (K10), and the sociodemographic profile scale. We used descriptive statistics to describe the prevalence of ACEs and psychological distress in our sample. After adjusting for the demographic covariates, ACEs' association with psychological distress was determined using binary and multivariate logistic regressions. RESULTS: A total of 203 students with a mean age of 20.76 ± 2.73 years completed the study. The total mean ACE score was 4.58 ± 1.59, and the total mean psychological distress score was 20.76 ± 6.31. Most of the participants (86.7%) experienced ACEs, 14.8% reported experiencing one ACE, 30.5% reported experiencing 2-3 ACEs, and 41.3% reported experiencing 4+ ACEs. Further, about 85% of the youth have experienced at least one form of sexual abuse during childhood, and females reported a higher number of ACEs than males. Sexual abuse (OR = 2.36; 95% CI: 2.36, 7.65), physical neglect (OR = 2.87; 95% CI: 1.57, 5.31), overall ACE exposure (OR = 6.66; 95% CI: 2.41, 18.42), having 1 ACE (OR = 4.40; 95% CI: 1.32, 14.70), having 2-3 ACEs (OR = 4.13; 95% CI: 1.39, 12.29), and having 4+ (OR = 11.67; 95% CI: 3.95, 34.45) were significantly associated with psychological distress. CONCLUSIONS: ACEs are prevalent among young adults and are associated with psychological distress in adulthood. Furthermore, parental factors are associated with ACEs and psychological distress. Thus, implementation of school, community-and facility-based routine mental health screening programs is essential for prompt identification, prevention, and treatment of youth with childhood adversities and poor mental health outcomes.

Relationship Between Physical Activity Levels and Psychological Well-Being Among Male University Students in South East, Nigeria: A Cross-Sectional Study.

This study aimed to evaluate the associations between physical activity (PA) and psychological well-being (PWB) among male university students. An institutionally based cross-sectional study was completed by 243 young men aged 18-30 years in a Nigerian public university. PA was measured using the International Physical Activity Questionnaire-Short Form (IPAQ-SF), and PWB was measured by Ryff's Scale of Psychological Well-being (PWB). The mean age of the participants was 24.9 (SD = 7.61) and majority (39.1%) of the participants was aged 18-22 years. Regarding PA, 16.0%, 64.2%, and 19.8% of the participants had low, moderate, and high PA levels, respectively. The mean total PWB score was 119.9 (SD = 23.64). For the domains of PWB, male students had mean scores of 25.73 (SD = 6.05), 19.42 (SD = 6.82), 25.75 (6.10), 14.12 (SD = 3.89), 13.70 (SD = 4.04) and 21.12 (4.92) for self-acceptance, autonomy, positive relations, environmental mastery, purpose in life and personal growth, respectively. Total PA (total MET min/week) was associated with the total PWB scores (ß = 0.13, p < .05). The total PA METs was significantly associated with self-acceptance (ß = 0.13, p < .05). positive relations (ß = 0.16, p < .05), purpose in life (ß = 0.39, p < .05). Vigorous PA METs showed significantly negative effect on personal growth (ß = -0.28, p < .05) and accounted for 2.0% of the variance of personal growth. PA accounted for 2.5% and 1.2% of the variance of positive relations and purpose in life, respectively., Most of the young men had moderate levels of PA and PWB. PA was significantly associated with PWB among the young men. Male sensitive evidence-based health promotion interventions should aim at promoting PA and PWB among male university students.

Co-infection and Risk Factors Associated with STIs among Pregnant Women in Rural Health Facilities in Nigeria: A Retrospective Study.

Globally, sexually transmitted infections are recognized as a public and reproductive health challenge. The study determined the prevalence, co-infection, and risk factors associated with HBV, HCV, HIV, and Syphilis infections among pregnant women receiving antenatal care in rural health facilities in Ebonyi State, Nigeria. A retrospective study was conducted from January to December 2018 in 8 primary healthcare facilities using antenatal records of all the 4657 pregnant women who attended ANC within the period. Data were analyzed using descriptive and inferential statistics with IBM SPSS statistics version 20 and hypotheses tested at P < .05. The findings indicated a medium prevalence of HBV (4.1%), a high prevalence of HCV (4.1%) and syphilis (1.8%), and a low prevalence of HIV (0.9%). An overall co-infection rate of 0.623% that was not significant (P > .05) was observed. Also, prevalence was more among the younger mothers (<20 years), those with secondary education. And the history of blood transfusion was significantly associated with HBV and HCV prevalence (χ2 = 7.865; P = .05*), 11.8%. conclusively, due to medium HBV prevalence and a high prevalence of HCV and syphilis observed, attention should be paid to blood screening before transfusion by health workers. Relevant stakeholders should provide intensive health education and appropriate free treatment services particularly for younger mothers and the less educated.

Nonadherence to tuberculosis treatment and associated factors among patients using directly observed treatment short-course in north-west Nigeria: A cross-sectional study.

INTRODUCTION: Tuberculosis is a public health problem in Nigeria. One of the most effective ways of controlling tuberculosis is the directly observed treatment short-course. However, some factors influence tuberculosis patients' treatment nonadherence via directly observed treatment short-course. The study objective was to assess medication nonadherence and associated factors among tuberculosis patients in north-west Nigeria. METHODS: A cross-sectional study enrolled tuberculosis patients using directly observed treatment short-course in public health facilities in Kano and Kaduna States from January 2015 to June 2016. The sample selection was conducted via a multistage sampling procedure. Data were collected using tuberculosis patients' demographic and clinical characteristics forms, well-validated structured instruments, and medical records. SPSS version 20 was used for data analysis. Logistic and multivariable logistic regression analyses to determine factors of medication nonadherence (P < 0.05). RESULTS: Complete responses from 390 patients out of the 460 patients recruited for the study were used for data analyses. The mean age was 51.5 (standard deviation = ±13.8) years. The mean tuberculosis medication adherence questionnaire score was 4.35 ± 1.12. The prevalence of nonadherence to tuberculosis medication was 30.5%. Multivariable logistic regression analysis showed that having a monthly income between #100,000 and #199, 000 (adjusted odds ratio = 0.01; 95% confidence interval: 0.00-0.13), being widowed (adjusted odds ratio = 26.74, 95% confidence interval: 2.92-232.9), being married (adjusted odds ratio = 120.49, 95% confidence interval: 5.38-271.1), having a distance <5 km to directly observed treatment short-course center from home (adjusted odds ratio = 0.06, 95% confidence interval: 0.00-0.01), having a tuberculosis/HIV co-infection (adjusted odds ratio = 0.01, 95% confidence interval: 0.12-0.35), use of antiretroviral treatment and cotrimoxazole prophylaxis therapy medications (adjusted odds ratio = 24.9, 95% confidence interval: 19.6-304.3) were associated with tuberculosis medication nonadherence. CONCLUSION: Tuberculosis medication nonadherence was high among the patients. Thus, patient-specific adherence education, attenuation of potential factors for tuberculosis medication nonadherence, and continual resource support for tuberculosis patients are needed to improve treatment outcomes.

Investigating Factors Associated with Immunization Incompletion of Children Under Five in Ebonyi State, Southeast Nigeria: Implication for Policy Dialogue.

Purpose. To investigate factors associated with immunization incompletion of children under 5 years in Ebonyi state, Southeastern part of Nigeria. Method. A cross-sectional and a cluster sampling design were implemented; 400 women of childbearing age in families with children between 0 to 59 months of age were interviewed in Ebonyi state. Demographic characteristics of the child and mother, the child's immunization history, and reasons for partial immunization were obtained with the use of a self-administered questionnaire. Data were analyzed using descriptive statistics of mean, standard deviation, t-test and ANOVA with SPSS version 23 and hypothesis tested at P < .05. Results. Findings revealed that 180 (48.1%) females, and 194 (51.9%) males' children were immunized; Less than half 155 (41.9%) of the children had 1 missed dose, considered as partial immunization cases indicating low coverage. Of the reasons given for incomplete immunization mothers, mothers agreed that immunization centers are far from home (x̄ = 2.55 ± 0.92). This reason significantly affects mothers who were young (≤20 years) (x = 2.86 ± 0.94; P = .018), single (x = 2.84 ± 1.05; 0.037), had secondary education (x = 2.65 ± 1.08;0.000), students (2.89 ± 1.08; P = .000), poor (x = 2.63 ± 1.05; P = .009), and primiparous (x = 2.50 ± 1.08; P = .036) are more affected and they agreed (grand mean >2.50). Conclusion. Immunization coverage was low, and far location from health facility was indicted thus policy implementers should locate health facilities close to homes. also health education on the importance of immunization should be given to mothers especially those who are young and has low socio-economic status.

Patients' satisfaction with quality of care in general hospitals in Ebonyi State, Nigeria, using SERVQUAL theory.

BACKGROUND: Patient satisfaction is an essential parameter in the assessment of quality of care and healthcare facility performance. OBJECTIVE: To investigate patients' satisfaction with quality of care in general hospitals in Ebonyi State, South East, Nigeria, using the SERVQUAL. METHODS: A cross-sectional descriptive study design was employed on a sample of 400 patients using a 27-item structured open-ended patients' satisfaction questionnaire with a multi-stage cluster sampling technique. Patients included in the study were those who must have come for an outpatient clinic within the period, be 18 years and above, and those who gave consent to participate. Of 400 questionnaires administered, 396 (99%) were retrieved. SPSS version 20 was used for data analysis. Descriptive statistics, such as frequencies, percentages, mean score (x), and standard deviation, were employed for interpretation. RESULTS: Out of 396 patients, 156 (39.4%) were male and 240 (60.6%) were females. Most patients were 18-39 years (233 (58.8%)), had secondary education (139 (35.1%)), married (221 (55.8%)), earned <18,000 (170(42.9%)), and were traders (136 (34.3%)). Patients were satisfied with tangibility (2.57 ± 0.99) and reliability (2.84 ± 0.95) and very satisfied with responsiveness (3.06 ± 0.63), assurance (3.07 ± 0.63), and empathy (3.12 ± 0.57). CONCLUSIONS: Patients were satisfied with the quality of care. However, satisfaction was highest with empathy and lowest with tangibility. Thus, managers should focus their quality improvement efforts on areas of the neat appearance of health workers, waiting facilities for attendants and patients, and hygienic conditions at the hospital. Also, biannual assessment of patients' satisfaction should be done and the results generated use judiciously to provide a platform for health sector reform.

Towards characterization of Female Genital Mutilation (FGM) in rural Nigeria.

BACKGROUND: Female genital mutilation (FGM) is a public health challenge and seems to be secretly practiced in some rural communities, despite the ban in Nigeria. OBJECTIVES: The study aimed to identify the activities that are involved in FGM, type(s) of FGM practiced and the knowledge of health implications of FGM among rural community members in Ebonyi State, Nigeria. METHODS: We employed exploratory design using qualitative technique. In-depth interviews were conducted with 44 adult (18 years and older) volunteers in four rural communities in Ebonyi State, Nigeria. After thematic analysis using NVivo 11 Pro software, eight sub-themes emerged, among which are: types of FGM practiced, seasons for FGM, FGM by health workers and community leaders, punishment for refusing FGM and knowledge of health implications of FGM. RESULTS: Findings show that FGM is more like a process than just an act, and type most practiced in the study area is Type 1. Circumcisers are health workers and women leaders. Knowledge of health implications of FGM was found to be low among those interviewed. CONCLUSION: Based on the findings, we concluded that FGM is still practiced in some rural communities in Nigeria, maybe because of poor knowledge of health implications of FGM.