Development and psychometric properties of an instrument to measure perception of aphrodisiac use among undergraduates in a southwestern Nigerian university.

A tool to measure perception of aphrodisiac use by undergraduates students of University of Ibadan, Oyo State, Nigeria was developed and validated. The study was hinged on several theories that could explain potential to use aphrodisiac among the youths. An exploratory mixed methods design was used to develop a scale to measure perception of aphrodisiac use by undergraduate students of University of Ibadan. Qualitative data collection was performed among thirty equally represented male and female students and five key informant interview participants while 919 participants completed the quantitative phase (surveys). Integration of matched qualitative themes from FGD/KII to survey domains was achieved through the 'building approach'. Qualitative themes assessing perceptions of aphrodisiac use by university undergraduate students were used to develop original survey items as well as new survey items peculiar to research subjects. Exploratory factor analysis was deployed on polychoric correlation matrix of the items using R-statistical packages. Further model fit analysis was conducted using confirmatory factor analysis on the items suggested by EFA as well as composite reliability and construct validity tests for the constructs. Mean Z-scores of factors were computed against socio-demographics and symptoms of aphrodisiac use among respondents that have ever used it. Most respondents (84.3%) were under 25 years, mostly male (58.4%) and singles (96.3%), with 41.3% earning ≤20,000 naira monthly. The enhanced content validity of the items from mixed method analysis yielded two major domains. Two succession of factor analyses and a structural equation modeling suggested that a first-order model is good fit for experimental data (TLI = 0.931; CFI = 0.948; SRMR = 0.047; RMSEA = 0.083). The four-factor solution to the model included: prolonged sexual performance, use without erectile dysfunction or medical advice, treatment of erectile dysfunction and recreational purposes with an internal and composite reliability that ranged from 0.62-0.92 and 0.63-0.92. The validation with socio-demographics and consequences of aphrodisiac use indicated that: Male respondents, those older than 20years, the married, those from poorly educated parent and sufferers of all related consequences had statistically significant differences with poor perception of aphrodisiac use' domains. This validated instrument is good for assessment of perception of aphrodisiac use among students in tertiary institution albeit with caution. A version of the scale that is broadened with highly refined items and tested for high internal validity is suggested.

Perception and prevalence of rape: A survey among in-school adolescents in rural Southwest Nigeria.

INTRODUCTION: Rape has fast become an issue of relevance to global health cutting across geographical and cultural divides. Most studies on the subject are urban based and among adults. This study was conducted to assess the perception, prevalence and perpetrators among in-school adolescents which represent a unique group and in a rural setting. METHODS: A cross-sectional study was conducted using a two-stage cluster sampling technique. A total of 640 respondents completed a pretested interviewer-assisted semi-structured questionnaire. Perception and knowledge scores for rape were calculated and data was analyzed using SPSS version 21. RESULTS: The mean age of respondents was 15.5 (±2.1) years and M: F ratio of 1:1.2. About one-half (46.9%) had poor overall knowledge of rape in the domains assessed. A significant proportion, 266 (41.6%) still subscribe to victim blaming in rape and 336 (52.5%) had negative perception of rape. Eight-five (13.3%) had been raped at least once while 36 (5.6%) self-reported to be perpetrators of rape. The respondents' sex (p=0.015) and present class (0.012) of respondents showed statistically significant association with knowledge of rape. CONCLUSION: The perception of in-school adolescents on rape still leaves much to be desired. Perpetration and experience of rape remain important global health issues.

Case control study of CD4 cell count and some haematological parameters among hepatitis and non-hepatitis B patients in Oyo State, South-west, Nigeria.

Aim: Hepatitis B virus HBV infection is a major cause of chronic liver disease worldwide. CD4 count and haematological parameters (HPs) could be used to monitor the health status of hepatitis B (HB) individuals. This study aimed at assessing levels of CD4 count and some HPs among sufferers of HB patients and controls. Methods: Fifty (50) HB patients as cases and 50 age-matched controls were recruited into the study. 5ml of whole blood sample was collected from all eligible participants of which 20µl and 10µl were used for CD4 count and HPs analysis respectively. Pearson correlation analysis was used to assess statistical difference within them using SPSS version 20. Results: There was significant increase between the normal values of the CD4 count of both cases and controls (p<0.05). Significant correlations were found in some HPs such as HCT with WBC; HB and RBC with PLT; RBC, HCT and PLT with WBC. Conclusion: There were no significant differences between the values of the CD4 count and hematological parameters among HB subjects in this study. There is need for future studies to detect changes in CD4 count and other HPs in HB patients to increase options of screening for immunological changes during management.

Contextual factors influencing the roles of patent medicine vendors in the provision of injectable contraception services in Nigeria.

BACKGROUND: Patent medicine vendors (PMVs) play vital roles in the delivery of family planning services in Nigeria and other developing countries. There is a growing recognition of the need to integrate them into the formal health care system as a strategy to increase the contraceptive prevalence rate and achieve universal health coverage. Though promising, the success of this proposition is largely dependent on a critical analysis of the factors which influence their operations. This study was designed to identify the contextual factors influencing the provision of injectable contraceptive services by PMVs and the broader effects of their activities on the health system to inform similar interventions in Nigeria. METHODS: This was a qualitative study guided by the UK Medical Research Council's Framework for Complex Interventions. Twenty-seven in-depth interviews were conducted among officials of the association of PMVs, health workers, government regulatory officers and programme implementers who participated in a phased 3-year (2015-2018) intervention designed to enhance the capacity of PMVs to deliver injectable contraceptive services. The data were transcribed and analyzed thematically using NVIVO software. RESULTS: The contextual factors which had implications on the roles of PMVs were socio-cultural and religious, the failing Nigerian health system coupled with government regulatory policies. Other factors were interprofessional tensions and rivalry between the PMVs and some categories of health care workers and increasing donors' interest in exploring the potentials of PMVs for expanded healthcare service provision. According to the respondents, the PMVs bridged the Nigerian health system service delivery gaps serving as the first point of contact for injectable contraceptive services and this increased contraceptive uptake in the study sites. A negative effect of their operation is the tendency to exceed their service provision limits, which has spurred a planned tiered PMV accreditation system. CONCLUSIONS: This study has highlighted the contextual factors which define the roles and scope of practice of PMVs involved in injectable contraceptive service provision. Strategies and interventions aimed at expanding the healthcare delivery roles of PMVs must be encompassing to address the broader contextual factors which underpin their capacities and functions.

Psychiatric morbidity among pregnant and non pregnant women in Ibadan, Nigeria.

A comparative cross-sectional study was conducted among 991 pregnant and 674 non-pregnant women of reproductive age attending healthcare facilities in Ibadan, Nigeria using the General Health Questionnaire-12 (GHQ), and WHO self-reporting questionnaire (SRQ). Logistic regression analysis was conducted to identify predictors of psychiatric morbidity at p < 0.05. A significantly higher proportion of pregnant women experienced psychological distress on the GHQ (51.8%) and psychiatric morbidity on SRQ (33.3%) compared with 28.6% and 18.2% of non-pregnant women, respectively. Predictors of psychiatric morbidity among pregnant women were the type of facility, poor satisfaction and communication with partners, the experience of violence in the home, previous abortions, and previous history of depression. Psychiatric morbidity among non-pregnant women was predicted by younger age, previous history of depression, poor satisfaction and communication with partners. There is a need for early identification of psychiatric morbidity among women of reproductive age, to ensure early interventions and prevent long-term disability.Impact statementWhat is already known on this subject? Psychiatric morbidity has immense effects on a woman's quality of life, social functioning, obstetric outcome, and economic productivity.What do the results of this study add? Psychiatric morbidity among women of reproductive age is high. Pregnant women when compared to non-pregnant women had significantly higher rates of psychiatric morbidity. This high prevalence of psychiatric morbidity in both groups was predicted by poor satisfaction and communication with partners, and a previous history of depression.What are the implications of these findings for clinical practice and/or further research? Simple screening for women of reproductive age attending healthcare facilities may help with the early identification of psychiatric morbidity leading to prompt interventions, and preventing long-term disability.

Knowledge of school teachers and the associating factors in the effective delivery of the school health programme in Nigeria.

Introduction: the important position that teachers occupy in school settings make them indispensable in the effective delivery of the School Health Programme (SHP). This study assessed the SHP knowledge of primary school teachers and the perception of their roles in the successful delivery of the programme in Ondo State, Nigeria. Methods: this was a cross-sectional descriptive study. A multi-stage sampling technique was used to select 400 teachers from 42 primary schools, from the study population. A semi-structured self-administered questionnaire was used to collect data. Each respondent´s aggregate score was classified as being poor knowledge, if it was < 50% of the maximum obtainable score and good knowledge, if it was equal or more than 50% of the maximum obtainable score. Results: the majority of the teachers (76%) demonstrated poor knowledge of the programme. Yet, a good number of them, believe they have a part to play in the implementation of the SHP. Academic qualification was found to be statistically associated with SHP knowledge (p < 0.01). Length of time in teaching service (p= 0.035; OR=1.033; 95%CI = 1.002- 1.065) was found to be a predictor of adequate SHP knowledge. Conclusion: the SHP knowledge of the teachers was found to be inadequate. Although, most of the teachers agreed that they had roles to play in the SHP delivery, a sizeable number of them could not state what those roles entailed. It is recommended, therefore, that government and all stakeholders in education and health sectors should conduct trainings on SHP, focusing on teachers´ roles in the school community.

Perception and intention to use reproductive life plan among female final year undergraduates of the University of Ibadan, Nigeria.

A descriptive cross-sectional study was conducted to assess perception (of) and intention to use reproductive life plan among 500 female final year undergraduates of the University of Ibadan, Nigeria. Only 22% of the respondents were aware of RLP and 63% had good perception of RLP. Most (85.1%) had the intention to plan their pregnancy and 64.5% intended to use RLP as a tool for planning pregnancy. More respondents (85.8%) who were aware of family planning methods had intention to plan their pregnancy compared to those that were not (61.5%; p = .015). Similarly, 65.8% of respondents who were aware of family planning methods had intention to use RLP compared to 23.1% of those who were not (p = .002). Respondents' awareness of the concept of RLP was poor and majority agreed to use RLP as a tool for planning pregnancy. Awareness of family planning methods was associated with intention to use RLP.Impact StatementWhat is already known on this subject? Reproductive life plan (RLP) is a tool for setting goals in terms of childbearing. It outlines personal goals about pregnancy which includes having the desired number of children, avoiding unintended pregnancies and avoiding ill health that may threaten reproduction. RLP is a useful tool in preconception and the tool can adequately prepare young unmarried girls for motherhood, thus reducing the high rate of unintended pregnancy which remains a public health and social challenge especially in low income settings including Nigeria.What do the results of this study add? This study has been able to bridge an existing gap in knowledge because no study has been conducted to assess the perception of RLP and intention to use it as a preconception tool in Nigeria. The results provided new information on the perception and intention to use reproductive life plan among female final year undergraduate students of University of Ibadan, Nigeria.What are the implications of these findings for clinical practice and/or further research? The use of RLP serves as health promotion strategy to improve the health of each woman prior to conception by planning their pregnancies, identifying risk factors, providing education and stabilising medical conditions so as to optimise maternal and foetal outcomes.

Social connectedness and health risk behaviours among in-school adolescents in urban and rural areas of Oyo State, Nigeria.

Adolescents are considered vulnerable due to their ability to venture into Health Risk Behaviours (HRBs) that may have a long-term detrimental effect on their total wellbeing. The major focus of previous adolescents' studies in Nigeria has been on parent-adolescent communication and the relationship it has with their academic performance and sexual behaviour; none has explored the association of social connectedness and HRBs among in-school adolescents. Thus, the aim of this study is to assess and compare social connectedness and HRBs among in-school adolescents in urban and rural areas of Oyo State. A school-based comparative cross-sectional design was employed wherein 2071 in-school adolescents were selected via a multistage cluster sampling in Ibarapa Central and Ibadan North Local Government Areas (LGAs) of Oyo State. The independent variables were socio-demographic characteristics, family characteristics and social connectedness while the dependent variable was HRBs. The data was analysed using descriptive statistics, chi square, t-test, ANOVA and logistic regression with level of statistical significance set at 5%. Overall, slightly over one-half of the respondents (51.9%) were from the urban LGA and 54.2% were females. The mean age of respondents was 13.7 ± 2.1 years and 46.7% were early adolescents aged 10-13 years. The prevalence of HRBs among in-school adolescents was high (91.8%) and the mean score of social connectedness among in-school adolescents was high, with a slightly higher mean in rural area (131.71 ± 16.43) compared to (131.04 ± 14.47) in urban area. However, this was not statistically significant (p = 0.322). The mean scores of the domains of religious connectedness (p = 0.176), school connectedness (p < 0.001), peer connectedness (p < 0.001) and social-media connectedness (p = 0.003) were higher in the rural areas. However, the mean score of family connectedness among respondents was higher in the urban area (p < 0.001). The odds of having engaged in HRBs were significantly 1.57 times more likely among respondents who were males than those who were females {AOR = 1.57, 95% CI: 1.12-2.19}. The odds of having engaged in HRBs was significantly 1.44 times more likely among respondents who live in an urban area than among those who live in a rural area {AOR = 1.44, 95% CI: 1.03-2.01}. For a unit increase in the total score of social-media connectedness of the students, the odds of having engaged in HRBs was reduced by 0.95 {AOR = 0.95, 95% CI: 0.92-0.99}. There were significantly lower mean scores for social connectedness among respondents who had engaged in HRBs compared to their counterpart who had not engaged in HRBs. Therefore, various efforts targeted at improving social connectedness with its domains could be recommended to prevent in-school adolescents from engaging in HRBs.

Process evaluation of an intervention to improve access to injectable contraceptive services through patent medicine vendors in Nigeria: a mixed methods study.

BACKGROUND: The low utilisation of modern contraceptives in many low- and middle-income countries remains a challenge. Patent medicine vendors (PMVs) that operate in the informal health sector, have the potential to address this challenge. Between 2015 and 2018, the Population Council, in collaboration with the Federal and State Ministries of Health and the Pharmacy Council of Nigeria, trained PMVs in six states to deliver injectable contraceptive services. Outcome evaluation demonstrated increased client uptake of injectable contraceptive services; however, there is limited information on how and why the intervention influenced outcomes. This study was conducted to elucidate the processes and mechanism through which the previous intervention influenced women's utilisation of injectable contraceptive services. METHODS: The study utilised a mixed methods, convergent parallel design guided by the UK Medical Research Council framework. Quantitative data were obtained from 140 trained PMVs and 145 of their clients in three states and 27 in-depth interviews were conducted among relevant stakeholders. The quantitative data were analysed descriptively, while the qualitative data were analysed thematically. RESULTS: The results revealed that even after the completion of the PMV study which had a time-bound government waiver for injectable contraceptive service provision by PMVs, they continued to stock and provide injectables in response to the needs of their clients contrary to the current legislation which prohibits this. The causal mechanism that influenced women's utilisation of injectable contraceptives were the initial training that the PMV received; the favourable regulatory environment as demonstrated in the approval provided by government for PMVs to provide injectable contraceptives for the duration of the study; and the satisfaction and the confidence the female clients had developed in the ability of the PMVs to serve them. However, there were gaps with regards to the consistent supply of quality injectable contraceptive commodities and in PMVs use of job aids. Referral and linkages to government or private-owned facilities were also sub-optimal. CONCLUSION: PMVs continue to play important roles in family planning service provision; this underscores the need to formalize and scale-up this intervention to aid their integral roles coupled with multi-faceted initiatives to enhance the quality of their services.

Determinants of anthropometric characteristics of under-five children in internally displaced persons´ camps in Abuja municipal area council, Abuja, Nigeria.

INTRODUCTION: displacement predisposes to deprivation and hunger and consequently malnutrition. In Nigeria, information on anthropometric characteristics and associated factors among displaced under-five children is important to strengthen strategies to ameliorate malnutrition and promote child health. This study was conducted to identify the determinants on anthropometric indices among under-five children in internally displaced persons' camps in Abuja, Nigeria. METHODS: this cross-sectional study involved 317 mother-child (0-59 months) pairs selected using two-stage simple random sampling technique. Information on socio-demographic, care practices (infant feeding, immunization, deworming) and anthropometric characteristics of index children was obtained using semi-structured, interviewer-administered questionnaire. Weight and length/height were assessed using standard procedure and analysed using World Health Organization (WHO) Anthro software. Data were analysed using descriptive statistics and logistic regression at p<0.05. RESULTS: median age was 24 months, 50.8% were male and 42.3% were delivered at health facility. Only 45.4% were exclusively breastfed, 28.8% were fed complementary foods too early, 45.4% were dewormed in the preceding six months and 43.9% had complete/up-to-date immunisation. Prevalence of underweight, stunting and wasting was 42%, 41% and 29.3%, respectively. Poor anthropometric indices were higher among male than female children, except wasting. Having good anthropometric index was 2.5 times higher among children <12 months than children ≥37 months (CI: 1.08-5.8), 2.4 times higher among 1st birth order than 5th orders (CI: 0.19-0.93), 1.7 times higher among female than male children (CI: 1.08-2.82). CONCLUSION: malnutrition is a major health problem among under-five children in internally displaced camps and major determinants include age, birth order, gender and deworming status.

General and tuberculosis-specific service readiness in two states in Nigeria.

BACKGROUND: Tuberculosis is the world's deadliest infectious disease and a leading cause of death in Nigeria. The availability of a functional healthcare system is critical for effective TB service delivery and attainment of national and global targets. This study was designed to assess readiness for TB service delivery in Oyo and Anambra states of Nigeria. METHODS: This was a facility-based study with a mixed-methods convergent parallel design. A multi-stage sampling technique was used to select 42 primary, secondary, and tertiary healthcare facilities in two TB high burden states. Data were collected using key informant interviews, a semi-structured instrument adapted from the WHO Service Availability and Readiness Assessment tool and facility observation using a checklist. Quantitative data were analysed using descriptive and inferential statistics while qualitative data were transcribed and analysed thematically. Data from both sources were integrated to generate conclusions. RESULTS: The domain score for basic amenities in both states was 48.8%; 47.0% in Anambra and 50.8% in Oyo state with 95% confidence interval [- 15.29, 7.56]. In Oyo, only half of the facilities (50%) had access to constant power supply compared to 72.7% in Anambra state. The overall general service readiness index for both states was 69.2% with Oyo state having a higher value (73.3%) compared to Anambra with 65.4% (p = 0.56). The domain score for availability of staff and TB guidelines was 57.1% for both states with 95% confidence interval [- 13.8, 14.4]. Indicators of this domain with very low values were staff training for the management of HIV and TB co-infection and training on MDR -TB. Almost half (47.6%) of the facilities experienced a stock out of TB drugs in the 3 months preceding the study. The overall tuberculosis-specific service readiness index for both states was 75%; this was higher in Oyo (76.5%) than Anambra state (73.6%) (p = 0.14). Qualitative data revealed areas of deficiencies for TB service delivery such as inadequate infrastructure, poor staffing, and gaps with continuing education on TB management. CONCLUSIONS: The weak health system remains a challenge and there must be concerted actions and funding by the government and donors to improve the TB healthcare systems.

Knowledge and perception of sexual and reproductive rights among married women in Nigeria.

Married women of reproductive age can experience violations of their sexual and reproductive rights (SRRs). Adequate knowledge and understanding of SRRs are critical to their ability to protect themselves. This mixed methods study assessed the knowledge and perception of SRRs among ever-married women in Ibadan Metropolis, Nigeria. Quantitative data (N = 423) were obtained using an interviewer-administered questionnaire and summarised by computing scores for knowledge and perception. Qualitative data were obtained from five focus groups. Findings showed that 45.2% of the respondents said that they were aware of SRRs, yet 81.8% had poor knowledge scores. Regarding perceptions about SRRs, 73% of respondents obtained scores over the mean. In focus group discussions, participants generally could not explain the meaning of SRRs. However, they had positive perception of some SRRs, such as rights to family planning and freedom from violence/abuse. Overall, this study revealed that respondents had poor knowledge of SRRs but positive perceptions about them. A concerted effort is needed to raise public awareness and achieve basic education for women of reproductive age.

Male partners' involvement in pregnancy related care among married men in Ibadan, Nigeria.

BACKGROUND: Maternal death remains a public health burden in the developing countries including Nigeria and the major causes are pregnancy related. Lack of male involvement in pregnancy related care is one of the contributing factors. Previous studies on male involvement focused on family planning services and were majorly targeted at women. This study, therefore, was carried out to assess the knowledge, perception and involvement of male partners in pregnancy related care among married men in Ibadan, Nigeria. METHODS: A cross sectional study was conducted using a four-stage sampling technique to select 367 married men in an urban community in Ibadan. A semi-structured, interviewer-administered questionnaire was used to obtain information on the knowledge, perception and involvement of respondents regarding pregnancy related care. Responses to questions on knowledge of pregnancy related care were converted to a 33-point scale. Scores greater than or equal to the mean knowledge score (26.2) were categorized as good knowledge of pregnancy related care. Similarly, responses to involvement in pregnancy related care questions were converted to a 24-point scale with scores greater than or equal to the mean (15.1) classified as good involvement in pregnancy related care. Data were analyzed using descriptive statistics and association between qualitative variables was established using Chi-square test at p < 0.05. RESULTS: Sixty-three percent had good knowledge of pregnancy related care. Majority believed that they had roles to play in their partners' care during pregnancy (89.9%), labor and delivery (92.9%), and in newborn care (97.5%). Overall, 56.9% had good involvement in pregnancy related care. About 20% followed their partners to antenatal care (19.6%) and postnatal (19.9%) clinics. A significantly higher proportion of respondents with good knowledge accompanied their partners for antenatal care (p = 0.008) and postnatal care clinic (p = 0.014); participated in birth preparedness (p < 0.001) and assisted with newborn care (p < 0.001). Job demands, social stigma and long waiting time at the health facilities were reasons highlighted for non-involvement in pregnancy related care. CONCLUSIONS: The study revealed gaps in knowledge and involvement in pregnancy related care. There is a need for reproductive health policy review to strongly emphasize the need for involvement of male partners in reproductive health issues including pregnancy related care.

Behavioural risk factors for non-communicable diseases among undergraduates in South-west Nigeria: knowledge, prevalence and correlates: a comparative cross-sectional study.

Low- and middle-income countries are experiencing a transition from a preponderance of infectious to Non-Communicable Diseases (NCDs). Many of the behaviours that produce these risks often commence in late adolescence. The study assessed the prevalence and knowledge of the major risk factors for NCDs among undergraduates in Ibadan Metropolis. This was a comparative cross-sectional study using a systematic random sampling technique. Data were collected using the WHO STEPs questionnaire and were entered and analysed using SPSS version 21. Data were analyzed with descriptive statistics, Chi-square test, and logistic regression at p < 0.05. Of 1,200 undergraduates, 646 (53.8%) were male and 1062 (88.5%) were aged 15-24 years; mean age was 20.4 (+/-3.5) years; 673 (56.1%) lived on campus. Only 3.1% of the respondents were current tobacco smokers. Also, 51.3% of respondents currently take alcohol with 11.2% classified as having excess alcohol use (> 6 standard drinks in one sitting in the last 30 days). About three quarters (70.6%) of respondents were classified as having unhealthy diets based on fruit/vegetable servings per day. Only 29.3% had adequate physical activity. Moreover, 48.3% were classified as having poor knowledge of the risk factors for NCDs. Overall, 99.3% of respondents had at least one behavioural risk factor. Public university undergraduates were more likely to have good knowledge of these risk factors OR 1.485 (95% CI: 1.485-2.398, p < 0.001). Behavioural risk factors for NCDs were prevalent among these undergraduates. Knowledge of NCD risk factors was average and those who attended public universities were more likely to have good knowledge of the risk factors for NCDs.

Mental health problems of reproductive age group women in a rural community of south west Nigeria.

Background: Mental health is a component of reproductive health which is generally not given priority in low and middle income countries. Efforts to improve women's health have focused majorly on issues associated with reproduction such as family planning and child-bearing while women's mental health has been relatively neglected.Aim: This study was conducted to determine prevalence and factors influencing mental health problems in non-pregnant reproductive age women in a rural community of south west Nigeria.Methods: A community-based cross-sectional survey was conducted using a cluster sampling technique to select the study population. Mental health was assessed based on respondents' experience of any symptoms of depression and anxiety. Data were analysed using descriptive statistics, Chi-square and multivariate logistic regression model at p < 0.05.Results: The mean age of the respondents was 25.6 ± 7.8 years. The prevalence of depression and anxiety was 28.9% each while 19.8% experienced both. Gynecological conditions were a predictor of anxiety (OR 2.7; 95% CI 1.3-5.6) while previous history of miscarriage was a predictor of depression (OR 10.5; 95% CI 1.0-108.8).Conclusions: Our study demonstrated that mental health problems were quite prevalent in women of reproductive age group. We recommend that mental health be integrated into reproductive health policies.

Child labor and mental health status of in-school adolescents in a municipal local government area of Lagos state, Nigeria.

BACKGROUND: Child labor (CL) is on the increase in developing countries with its adverse consequences. Many studies have related CL to physical and social well-being and not mental health (MH). This study was designed to assess the experience of CL and mental health status (MHS) among in-school adolescents and determine the association between them, if any, in a metropolitan area of Lagos state, Nigeria. METHODS: A descriptive cross-sectional study was conducted in eight private and four public secondary schools using a two-stage cluster sampling method. A semi-structured, self-administered questionnaire was used to obtain information on CL and MH. Experience of CL was assessed through a "yes" or "no" response to whether respondents had ever worked or were currently working in exchange for money or not. MHS was measured with the Strength and Difficulty Questionnaire (SDQ). The SDQ is a 25-item instrument with two subdivisions: strength (prosocial) and difficulty scales. Difficulty scale is categorized into emotional, conduct, hyperactivity and peer problems. Each category of the subdivision was scored as normal (low need), borderline (some need) and abnormal (high need). The scores were modified into "positive" (low need) and "negative" (some need and high need). Total difficulty was scored "positive" (0-15) and "negative" (16-40) and prosocial behavior was scored "positive" (6-10) and "negative" (0-5). Data were analyzed with descriptive statistics, Chi-squared test and logistic regression at α < 0.05. RESULTS: The mean age of respondents was 14.1 ± 1.9 years with 61.4% aged 14 years and above and 59.2% were female. About a quarter (23.8%) experienced CL with apprenticeship being the most common form (55%) followed by street trading (10%). About 20% of the respondents had negative MHS on the overall difficulty scale and 8.0% on the prosocial scale. Based on the ratings of the difficulty scale, 39.1% of them had problems with peers, 19.3% had emotional problems, 17.2% had conduct problems and 7.6% were hyperactive. Sex, mothers' and fathers' levels of education, and school absenteeism were predictors of CL experience. Respondents who lived with both parents had lower odds of having negative MHS [adjusted odds ratio (AOR) = 0.39; 95% confidence interval (CI) = 0.187-0.815]. CONCLUSION: The study revealed that among in-school adolescents in the study area, a considerable percentage of children were involved in CL and had poor MHS especially peer and conduct problems. Concerted efforts at reducing the menace of CL and interventions to promote the MH of in-school adolescents are hereby advocated.

Association between Sex, CD4 Cell Counts, Antiretroviral Medications, and Olfactory and Gustatory Functions of HIV-Infected Adults.

Objective To investigate the olfactory and gustatory functions of human immunodeficiency virus (HIV)-infected adults in Ibadan, Nigeria. Study Design A cross-sectional study of olfactory and gustatory functions of HIV-infected adults between March 2015 and December 2015. Setting Tertiary health institution. Subjects and Methods A structured questionnaire was administered to participants to obtain relevant sociodemographic and clinical information. Participants' nadir and most recent CD4 cell count and viral loads were obtained from their medical records. Participants' body mass indices were determined, and each subjectively rated their olfactory and gustatory performances. Objective olfactory and gustatory functions were determined using validated "Sniffin' Sticks" and "Taste Strips" impregnated with 4 different concentrations of sucrose, quinine hydrochloride, sodium chloride, and citric acid. Results In total, 135 HIV-infected adults, comprising 41 (30.4%) men and 94 (69.6%) women, were evaluated. Their ages ranged from 20 to 70 years, mean 43.4 ± 10.4 years. Participants were on highly active antiretroviral therapy for a mean duration of 75.8 ± 36.9 months. The proportions of male participants in HIV stages 1, 2, and 3 were 18 (43.9%), 19 (46.3%), and 4 (9.8%), respectively, while female participants were 46 (48.9%), 41 (43.6%), and 7 (7.4%), respectively. Participants' mean olfactory threshold, discrimination, identification, and TDI scores were 8.0 ± 4.9, 9.9 ± 4.7, 8.8 ± 4.5, and 26.7 ± 11.1, respectively, while total taste score was 25.1 ± 5.7. Conclusion HIV-infected adults have tendency to develop hyposmia and hypogeusia. These are worse with advanced stage of HIV infection.

Family planning services in a tertiary hospital in a semi-urban area of south-western Nigeria: Uptake and determinants of contraceptive use.

An audit of 954 family planning clinic attendees, who received counselling from 2006 to 2010, was conducted at the only federal government owned tertiary hospital in Ondo state, Nigeria. Of these, 637 (66.8%) accepted a family planning method: 47.6% chose injectables, 23.2% intrauterine device, 19.5% oral contraceptive pills, 4.4% barrier methods, 3.3% implants and 2% tubal ligation. Clients who had some primary education [OR: 2.79; (95% CI: 1.14-6.84; p < 0.05] had statistically significant higher odds of accepting any contraceptive method while those with elevated blood pressure at first visit [OR: 0.23; 95% CI: 0.12-0.45; p < 0.001] and those with previous episode(s) of induced abortion OR: 0.57; 95% CI: 0.43-0.76; p < 0.001] had statistically significant lower odds of using any method. Concerted efforts at increasing uptake is advocated to bridge the gap between client counselling and uptake.

Disclosure to sexual partner and condom use among HIV positive clients attending ART clinic at a tertiary health facility in South West Nigeria.

INTRODUCTION: Condom use and disclosure of HIV status increase the safety of sexual activity. Its extent will determine the need for appropriate interventions. The objective of this study was to identify determinants of condom use and disclosure to sexual partners among individuals receiving Antiretroviral Therapy at a tertiary health facility in South West Nigeria. METHODS: A cross-sectional study of 578 clients enrolled in the ART program of Federal Medical Centre Owo, Ondo State Nigeria, was conducted. RESULTS: The mean age of respondents was 38.6+9.6 years, more than half (66.6%) were females and 7% were currently married. Three-quarter were sexually active out of which 324(75.9%) used condom consistently and correctly and 323(75.6%) disclosed their status to their sexual partner. Use of condom was by 81% of those with tertiary education (p=0.002), and 84.5% of singles utilized condom (p<0.001). Determinant of condom use were, male (OR: 2; CI: 1.1- 3.3; p=0.013), secondary and tertiary education (OR: 3.69; CI: 1.48 - 9.19; p=0.005) and (OR: 4.79; CI: 1.84 - 12.44; p=0.001) respectively. Determinant of disclosure was being married (OR: 11.8; CI- 5.5-25.7; p<0.001). No significant association exist between disclosure and condom use. CONCLUSION: Most of the people living with HIV accessing ART were sexually active. A good proportion of them used condom consistently and correctly. Disclosure did not have significant effect on condom use. More health education intervention to increase disclosure rate and safe sexual behaviour among HIV positive clients is needed.

Erectile dysfunction among male hypertensives in a tertiary health facility in South-West Nigeria.

INTRODUCTION: Erectile dysfunction (ED) has been associated with hypertension and some other chronic diseases. There are few studies on ED in Nigerian male hypertensives and ED appears to be under-reported. We sought to determine the prevalence of ED among hypertensive and normotensive men and to assess the association of demographics, hypertension, antihypertensive medications and other risk factors with erectile function. METHODS: A comparative cross sectional study was conducted among male adult hypertensive and normotensive patients attending the outpatient clinic of a tertiary hospital in South-West Nigeria. A systematic random sampling method was employed for the selection of respondents. Participants were interviewed using a semi-structured questionnaire to document socio-demographic data, medical history, social history and degree of ED. Demographic and anthropometric characteristics was obtained from all participants. The International Index of Sexual Health Inventory for men (SHIM) was used to determine the presence and severity of ED. Association between categorical independent variables and erectile function were tested using Chi square and the predictors of erectile dysfunction determined with binary logistic regression model at 5% level of significance. RESULTS: A total of 202 male patients completed the study (101 with established hypertension and 101 normotensives who served as comparative group). The mean age of the respondents was 49.74 ± 16.6 years. A total of 133 (65.8%) respondents had ED in varying severities while 34.2% had normal erectile function. Mild to moderate ED occurred in 29.7% while 36.1% had severe ED. On bivariate analysis, prevalence of ED was higher among hypertensives (75%) than normotensives (56.9%) and this was statistically significant, p = 0.007. On multivariate analysis, the only significant risk factor for ED was age. The elderly aged ? 65 years (OR: 2.9; 95% CI: 1.03-8.35; p = 0.04) and those aged 46-64 years (OR: 2.9; 95% CI: 1.38-6.53; p = 0.006) were 3 times each more likely to have erectile dysfunction compared with those aged ? 45 years. CONCLUSION: This study revealed that erectile dysfunction was prevalent in both hypertensive and normotensive population studied and that this was significantly worse with increasing age. A higher proportion of hypertensives compared to normotensives had erectile dysfunction. We recommend that all men presenting to a physician should have routine evaluation for ED so as to recognise it early and reduce its effects.