Impact of health education intervention on knowledge and perception of cervical cancer and cervical screening uptake among adult women in rural communities in Nigeria

BACKGROUND

Cervical cancer is a disease of public health importance affecting many women and contributing to avoidably high levels of cancer deaths in Nigeria. In spite of the relative ease of prevention, the incidence is on the increase. This study aimed to determine the effect of health education on the awareness, knowledge and perception of cervical cancer and screening among women in rural Nigerian communities.

METHODS

The study design was quasi-experimental. The study was carried out among adult women in Odogbolu (intervention) and Ikenne (control) local government areas (LGA) of Ogun state. Three hundred and fifty (350) women were selected per group by multistage random sampling technique. Data was collected by semi structured interviews with the aid of questionnaire. The intervention consisted of structured health education based on a movie.

RESULT

The intervention raised the level of awareness of cervical cancer and screening to 100% (p < 0.0001). The proportion of women with very good knowledge of cervical cancer and screening rose from 2% to 70.5% (χ(2) = 503.7, p < 0.0001) while the proportion of those with good perception rose from 5.1% to 95.1% (p < 0.0001). The mean knowledge and mean perception scores were also increased (p < 0.0001). There was increase in the proportion of women who had undertaken cervical screening from 4.3% to 8.3% (p = 0.038). The major reason stated by the women for not having had cervical screening done was lack of awareness about cervical cancer and screening. There was statistically significant difference between the intervention and control groups concerning their knowledge attitude and practice towards cervical and screening (p < 0.05) after the intervention.

CONCLUSION

Multiple media health education based on a movie is effective in creating awareness for and improving the knowledge and perception of adult women about cervical cancer and screening. It also improves the uptake of cervical cancer screening. The creation of awareness is very crucial to the success of a cervical cancer prevention programme.

A comparative analysis of teenagers and older pregnant women in the utilization of prevention of mother to child transmission [PMTCT] services in, Western Nigeria

INTRODUCTION

Most HIV/AIDS infections in women occur at a younger age, during the first few years after sexual debut. This study was therefore designed to assess factors associated with the knowledge and utilization of the prevention of mother-to-child transmission (PMTCT) services by the teenage pregnant women when compared to mature pregnant women in Ogun state, Nigeria.

METHODS

This study is an analytical cross-sectional study. A total sample of all pregnant women [52 teenagers and 148 adults] attending the primary health care centres in Sagamu local government area, Ogun State, Nigeria within a 2 months period were recruited into the study.

RESULTS

A total of 225 respondents were recruited into the study. The overall point prevalence of HIV/AIDS infection among those that had been tested and disclosed their result was 4 [2.8%]. The prevalence of HIV among the teenagers was 2 [7.4%] compared with 2 [1.8%] among older women. Only 85 [37.8%] of all respondents were tested through the Voluntary counseling and testing (VCCT) programme and 53 (23.7%) were aware of antiretroviral therapy while 35 (15.6%) have ever used the PMTCT services before.There was no statistically significant difference in the knowledge of the teenage pregnant women when compared with the older women about mother to child transmission (MTCT) [OR = 1.47, C.I = 0.57-3.95] and its prevention [OR = 0.83, C.I = 0.38-1.84]. The teenagers were 3 times less likely to use the services when compared with the older women. [OR = 0.34, C.I = 0.10-1.00]. Those from the low socio-economic background were about 6 times more likely to utilize PMTCT facilities when compared to those from high socioeconomic background [OR = 6.01, C.I = 1.91-19.19].

CONCLUSION

The study concludes that the teenage pregnant women who were more vulnerable to HIV/AIDS infection did not utilize PMTCT services as much as the older pregnant women. Special consideration should be given to teenagers and those from high socioeconomic group in the design of scale up programmes to improve the uptake of PMTCT services in Nigeria and other low income countries.

Community awareness of bird flu and the practice of backyard poultry in a North-Central state of Nigeria

INTRODUCTION

The practice of backyard poultry is a very common practice in many homes in Nigeria. Birds raised at home are usually free ranged, which increases close contact between man and birds, thus increasing the risk of transmission of avian influenza virus to man. This study investigated the awareness of bird flu infection and identifies risk factors associated with the practice of backyard/free ranged poultry among the residents of a state in Northern Nigeria.

METHODS

This cross-sectional study was carried out in Kwara State using 130 wards selected through cluster sampling technique. Households in each ward were sampled through systematic random sampling technique using the primary health care house numbering register. Semi-structured questionnaire was used to generate relevant information through interview and 650 participants consented and were used for the study.

RESULTS

Most of the respondents 604 (92.9%) kept birds in their homes and one-third 204 (33.8%) of this group knew that infection from birds can be transmitted to man. However, less than a third 186 (30.8%) of those who keep birds were aware of avian influenza (AI) infection. Out of the 186 respondents, 78 (41.9%) had experienced massive bird deaths in the preceding year prior to the interview. Less than half 81 (43.5%) were willing to report AI or massive deaths occurring in flocks of their birds to designated officers /authority. During outbreaks with massive deaths in birds some of the respondents sold infected live birds 45 (57. 7%), few slaughtered and dressed the birds before sale 11 (14.1%), while some slaughtered and consumed the birds in their families 19 (24.4%).

CONCLUSION

The practice of backyard poultry is very high with little knowledge and awareness of mechanism and risk of infection associated with it. This was also reflected in their attitude towards reporting of outbreaks in birds. Public awareness campaign and home visit by environmental and veterinary officers are important strategies that can prevent AI infection transmission among domestic birds and man.

Detection of mental disorders with the Patient Health Questionnaire in primary care settings in Nigeria

Mental disorders lead to difficulties in social, occupational and marital relations. Failure to detect mental disorder denies patients potentially effective treatment. This study aimed to assess the prevalence and nature of mental disorders at the primary care settings and the recognition of these disorders by the attending physicians. Over a period of eight weeks, consecutive and consenting patients who attended three randomly selected primary health care facilities in Sagamu Local Government Area of Ogun state were recruited and administered a questionnaire that included a socio-demographic section and Patient Health Questionnaire (PHQ). A total of 412 subjects took part in the study. Subject age ranged from 18–90 years with a mean age of 52.50±21.08 years. One hundred and seventy-six (42.7%) of the subjects were males. A total of 120 (29.1%) of the subjects had depressive disorder, 100 (24.3%) had anxiety disorder, 196 (47.6%) somatoform disorder and 104 (25.2%) met the criteria for an alcohol related problem. The PHC physicians were only able to diagnose disorders relating to mental health in 52 (12.6%) of the subjects. Health and work situations accounted for more than three-quarters of the causes of stress experienced by the subjects. We conclude that there is a high prevalence of mental disorders among patients seen in primary care settings and that a significant proportion of them are not recognized by the primary care physicians. Stress relating to health, work and financial problems is common among primary health care attendees. Physicians in primary health care should be alert to the possibility and the impact of undetected psychiatric morbidity.

Assessment of violence against women in Kano metropolis, Nigeria

BACKGROUND

Violence against women, in its various forms, is endemic in communities and countries around the world, cutting across class, education, race, age, religious and national boundaries.

AIMS AND OBJECTIVES

This descriptive cross-sectional study was conducted to identify various forms of gender based violence affecting women in Kano metropolis, determine factors responsible for gender based violence and use this to suggest ways of preventing gender based violence.

SUBJECTS AND METHODS

Respondents for this study were selected from the eight metropolitan Local Government Areas of Kano State, Nigeria. Six hundred adult males and females were selected through a multi-stage sampling technique by the use of questionnaire as the data tool.

RESULTS

More than three quarters 436 (75.7%) of the respondents knew that women are subjected to various forms of verbal abuse in their homes by their spouses. Deprivation of assess to health care and education was identified by 454 (78.8%) and 490 (85.15) respondents as challenges faced by women at homes. Majority of the respondents 498 (86.4%) identified financial reason, four hundred and forty (76.4%) respondents mentioned unfaithfulness and three-quarters 434 (75.3%) of the respondents said refusal of sexual advance is a reason for violence activities witnessed by women in their respective homes. There was a statistically significant relationship in opinion of male and female on coercion of wife for sexual activities when she is tired and when she is not in the mood (p-value=0.0000).

CONCLUSION

Government and Non Governmental organisation should intensify activities to promote awareness and advocacy on violence against women. Involvement of males in all programmes relating to violence against women should be done especially since the perpetrators in most cases are men.

Postpartum sexual abstinence and breastfeeding pattern in Sagamu, Nigeria

This was a prospective study involving 371 mothers. The mean age of the mothers was 27.5 (.3.6) years with a mean years at school (Educational years) of 11.3 (2.9) years. All the mothers had previously breastfed at one of their infants for at least 6 months, while the mothers also breastfed their last child for an average (mean) of 10.3 (4.0) months. The overall mean of previous live births was 1.9 (0.8). In the first month postpartum, 84.6% of the mothers abstained from sexual intercourse, but by the 4th-5th month the proportion had dropped to 18.1%, with just 2.1% of the study population abstaining from sexual intercourse at 11-15 months post-partum. Forty seven (13.5%), 30 (8.6%) and 3 (0.9%) mothers in social classes 2,3 and 1 respectively have resumed sexual intercourse at 4-5 months, while only 12 (3.4%) and 4 (1.1%) in social classes 2 and 3 respectively continued with sexual intercourse at 11-15 months. More mothers resumed sexual intercourse from 1 to 15 months post-partum when they breast fed for 6-10 minutes and 11-15 minutes than those who breast fed for 1-5 minutes, 16-20 minutes and 21-25 minutes. Also more mothers within the 25-29 years age group resumed sexual intercourse from the first month to the fifteenth month post-partum than mothers in the other age groups.

HIV sero-prevalence among newly diagnosed adult pulmonary tuberculosis patients in Sagamu

BACKGROUND

[corrected] The association between Tuberculosis (TB) and Human immunodeficiency virus (HIV) has been described in several studies. TB was well represented in the first description of AIDS in Africa. In 1999, 25% of TB cases were attributable to the spread of HIV/AIDS. Frequencies of between 54-79% were recorded in medical in-patients in our hospital. The objective of the study is to assess the frequency of HIV in TB outpatients attending the tuberculosis and leprosy control centre in Sagamu.

METHODS

A cross-sectional study of adult tuberculosis patients admitted into the DOTS programme of the TB and leprosy control centre, Olabisi Onabanjo University Teaching Hospital, Sagamu between January 2001 and December 2002 was undertaken. Free anti tuberculosis drugs were provided by the German leprosy Relief Association. Data was collected using interviewer-administered questionnaire. HIV screening, packed cell volume and sputum microscopy for acid fast bacilli were carried out on all patients.

RESULTS

A total of 269 cases of pulmonary T.B were registered at the clinic of which 40 (14.9%) were HIV sero-positive. The peak age prevalence was in the 3d decade accounting for 42.5% of cases, followed by 32.5% in the 2rd decade. There was a statistically significant difference in the bacillary count and packed cell volume between HIV positive and negative TB patients. The mean weight at presentation, sputum positivity rate and sputum conversion rate at the end of two months of therapy was similar in both HIV positive and negative TB patients.

CONCLUSION

This study has demonstrated a frequency of 14.9% of HIV sero-prevalence amongst our TB population. Efforts should be intensified to ensure adherence to INH prophylaxis among HIV infected individuals in TB endemic areas as well as strengthening preventive measures.

Infant feeding and lactational amenorrhea in Sagamu, Nigeria

Five hundred and twenty educated, breastfeeding women in Sagamu, Nigeria, were observed prospectively in order to describe their infant feeding practices and to determine whether any predictors of the return of menses could be identified. The women remained amenorrheic for seven months. Compared with similarly selected women in other countries, they regularly fed their infants with supplements from a very early age, yet breastfeeding frequency and duration did not decline dramatically. Semi-solid food was introduced at about four months and such supplementation, as well as earlier supplementation with milk/milk-based feedings, was associated with the return of menses. The median duration of abstinence was about four months but the mean may have been much longer. No woman became pregnant until her infant was weaned.

Studies on the effectiveness, safety and acceptability of fluids from local foodstuffs in the prevention and management of dehydration caused by diarrhoea in children

Two fluids derived from local staple food, Manioc Salt Solution (MSS) and Pap Salt Solution (PSS) were assessed and compared with the World Health Organization/Oral Rehydration Solution (WHO/ORS) in 333 children aged between 6 and 60 months in a clinical trial. All the children had some dehydration after episodes of acute watery diarrhoea using WHO criteria. All the children who were placed on MSS and PSS, as well as ORS were satisfactorily rehydrated. There was no significant difference in pre- and postserum electrolytes of the children on the three types of fluids. The fluids were found to be acceptable, readily available, easy to prepare and cheaper than the ORS fluid. There was no taboo against the fluid. It is noteworthy that there was no significant difference in the sugar and electrolyte contents of the different varieties of the manioc and pap available in this environment, thus making the MSS and PSS effective and readily available substitutes to ORS. The two fluids are therefore recommended as rehydrating fluids for children with some dehydration in the absence of WHO/ORS fluid.