Perception of Genetic Testing for Deafness and Factors Associated with Interest in Genetic Testing Among Deaf People in a Selected Population in Sub-Saharan Africa.

Understanding the perceptions of genetic testing by members of the deaf community may help in planning deafness genetics research, especially so in the context of strong adherence to cultural values as found among native Africans. Among Yorubas in Nigeria, deafness is perceived to be caused by some offensive actions of the mother during pregnancy, spiritual attack, and childhood infections. We studied attitudes towards, and acceptance of genetic testing by the deaf community in Nigeria. Structured questionnaires were administered to individuals sampled from the Vocational Training Centre for the Deaf, the religious Community, and government schools, among others. The main survey items elicited information about the community in which the deaf people participate, their awareness of genetic testing, whether or not they view genetic testing as acceptable, and their understanding of the purpose of genetic testing. There were 150 deaf participants (61.3 % males, 38.7 % females) with mean age of 26.7 years ±9.8. A majority of survey respondents indicated they relate only with other members of the deaf community (78 %) and reported believing genetic testing does more good than harm (79.3 %); 57 % expressed interest in genetic testing. Interest in genetic testing for deafness or in genetic testing in pregnancy was not related to whether respondents relate primarily to the deaf or to the hearing community. However, a significantly higher number of male respondents and respondents with low education reported interest in genetic testing.

Pneumonia hospitalizations and mortality in children 3 - 24-month-old in Nigeria from 2013 to 2020: Impact of pneumococcal conjugate vaccine ten valent (PHiD-CV-10).

Pneumococcal conjugate vaccine ten valent (PCV 10) was introduced into Nigeria in three phases. Phase 3 introduction started in August 2016. However, its impact on pneumonia admissions and mortality among vaccinated Nigerian children has not been determined. Data in the period before PCV-10 introduction (3 August 2013-2 August 2016), and after (3 August 2017-2 August 2020) were retrospectively extracted from the medical charts of eligible patients aged 3-24 months with hospitalized radiological pneumonia at the University College Hospital (UCH), Ibadan; National Hospital (NH), Abuja; and Federal Teaching Hospital (FTH), Gombe, allowing for an intervening period of 1 year. Proportions of the patients with hospitalized pneumonia and case fatality rates were determined during both periods. The results were compared using z-test, multiple logistic regression analysis and p < .05 was considered significant. Adjusted pneumonia hospitalization rates between the two periods increased at the NH Abuja (10.7% vs 14.6%); decreased at the UCH, Ibadan (8.7% vs 6.9%); and decreased at the FTH, Gombe (28.5% vs 18.9%). Case fatality rates decreased across all the sites during the post-PCV introduction period: NH Abuja, from 6.6% to 4.4% (p = .106); FTH, Gombe, 11.7% to 7.7% (p = .477); and UCH, Ibadan, 2.0% to 0% (p = .045); but only significant at Ibadan. Overall, proportion of hospitalized pneumonia cases decreased after 3 years of PCV 10 introduction into the National Immunization Programme in Nigeria. The case fatality rate during post-PCV 10 introduction decreased at all the three sites, but this difference was significant at the UCH, Ibadan.

Pneumonia is the commonest killer of Nigerian children aged less than 5 years. Pneumonia vaccine (PCV 10) was introduced into Nigeria Vaccination Program between 2014 and 2016, but up till now the value has not been confirmed. We conducted a retrospective study in which data before and after PCV 10 introduction were compared. The study sites were the University College Hospital (UCH), Ibadan; National Hospital (NH), Abuja; and Federal Teaching Hospital (FTH), Gombe. The data were extracted from the medical charts of eligible patients aged 3­24 months who were admitted for severe pneumonia with evidences on lung radiographs. We found that the proportion of hospitalized pneumonia cases decreased after 3 years of PCV 10 introduction into the National Immunization Program in Nigeria. The death rate during post-PCV 10 introduction decreased at all the three sites, but was only significantly decreased at the UCH, Ibadan.

Survival probability and predictors for woman experience childhood death in Nigeria: "analysis of North-South differentials".

BACKGROUND: Childhood mortality rate is high in Nigeria. There is dearth of information on the comparison of childhood mortality probability and its causal factors in the Northern and Southern Nigeria. This study was designed to fill these gaps. METHODS: Nigeria Demographic and Health Survey, 2008 data was used. The first part of this study focused on women aged 15-49 who ever given birth to a child (n = 23,404), irrespective of the survival status of the child and the second part utilized all women aged 15-49 (N = 33,385). The outcome variable was experienced childhood mortality. Data was analyzed using Chi-square, logistic regression and Brass logit model. RESULTS: Results showed that similar patterns of children's death were observed in the two regions, but variation existed. Childhood mortality experienced was more pronounced in the North than the South, even when the potential confounding variables were used as control. Levels of education and wealth index showed an inverse relationship with childhood death in the regions (p < 0.05). The gap in childhood mortality experienced between the poorest and richest was wider in the North than the South. There was no significant difference in the risk of childhood mortality experienced by women in the urban and rural areas in the North (p > 0.05), but the difference was significant in the South (p < 0.05). The life-table mortality levels were lower in the North than the South, an indication of higher previous childhood mortality experience in the North than in the South. Across all childhood ages, the smoothed childhood mortality probabilities were consistently higher in the North than the South. CONCLUSION: Childhood mortality is higher in the Northern than Southern Nigeria. Improving women's education, particularly in the North will alleviate childhood mortality in Nigeria.

Intimate partner violence and primary health care workers: screening and management.

OBJECTIVES: To assess knowledge, attitude and management practices on intimate partner violence (IPV) in primary care practice and determine barriers to screening, safety concerns and prior training of health workers. METHODS: Self administered questionnaire interview of 298 health workers from 104 health facilities in the 33 local government areas of Oyo state. RESULTS: Health workers underestimated IPV, 80% estimated that less than 10% of women in their practice experience violence. Only 35% (105) screened routinely for IPV, while 43% (129) had ever identified a victim. Response of health workers when they found oppressed women were often (64.5%) limited to treatment of injuries. Many (66.1%) believed it was an intrusion into patient's private life to inquire about violence. Ninety per cent (270) expressed concern for their personal safety if they were to discuss with the oppressed or perpetrators. Many (74.8%) believed that they could assist men who perpetrate violence, while 92.3% believed they could assist abused women. Only 18.8% (56) had ever received training on violence. Health workers with previous training on IPV were three times more likely to screen (AOR 2.66; 95%CI: 1.52-4.63), while the more senior cadre were more likely (AOR 1.62; 95% CI: 1.13-2.81) to have identified an oppressed woman. Although not significant, females had better knowledge and attitudes than men (OR 0.67; 0.96-2.94 and 0.78; 0.44-1.40). CONCLUSIONS: Health workers were willing to discuss IPV, but lacked fundamental knowledge on IPV. Training efforts that focus on screening and comprehensive management are urgently required.

Trends in the prevalence and severity of symptoms of asthma, allergic rhinoconjunctivitis, and atopic eczema.

The increase in prevalence of asthma and other allergic diatheses has rarely been documented in the developing sub-Saharan countries. We assessed time trends in symptoms of asthma, allergic rhinoconjunctivitis, and atopic eczema among children in Ibadan, Nigeria, with cross-sectional data from 2 International Study of Asthma and Allergies in Childhood questionnaire-based surveys conducted 7 years apart in 1995 and in 2001-2002. The prevalence of current wheeze increased nonsignificantly in the 6- to 7-year age group (4.8%-5.5%) and significantly in the 13- to 14-year age group (10.7%-13.0%) (p = .249 and p = .005, respectively). The 12-month prevalence of allergic rhinoconjuctivitis decreased insignificantly in the 6- to 7-year age group (p = .833) but significantly in the 13- to 14-year age group (p = .001), while the diagnosis of atopic eczema decreased in both age groups. The current findings suggest that the symptoms of asthma have only increased significantly in the Nigerian adolescents.

Intermittent preventive treatment with sulphadoxine-pyrimethamine is effective in preventing maternal and placental malaria in Ibadan, south-western Nigeria.

BACKGROUND: Intermittent preventive treatment with sulphadoxine-pyrimethamine (IPT-SP) is currently the recommended regimen for prevention of malaria in pregnancy in endemic areas. This study sets out to evaluate the effectiveness of IPT-SP in the prevention of maternal and placental malaria in parturient mothers in Ibadan, Nigeria, where the risk of malaria is present all year round. METHOD: During a larger study evaluating the epidemiology of congenital malaria, the effect of malaria prophylaxis was examined in 983 parturient mothers. Five hundred and ninety eight mothers (60.8%) received IPT-SP, 214 (21.8%) received pyrimethamine (PYR) and 171 (17.4%) did not take any chemoprophylactic agent (NC). RESULTS: The prevalence of maternal parasitaemia in the IPT-SP, PYR and NC groups was 10.4%, 15.9% and 17% respectively (p = 0.021). The prevalence of placental parasitaemia was 10.5% in the IPT-SP, 16.8% PYR and 17% NC groups, respectively (p = 0.015). The prevalence of maternal anaemia (haematocrit <30%) was 5.7% vs. 8.9% vs. 13.4% among the IPT-SP, PYR and NC groups respectively (p < 0.0001) while that of pre-term delivery (GA <37 weeks) was 10.5%, 19.2% and 25.3% among IPT-SP, PYR and NC groups respectively (p < 0.0001). Babies born to mothers in the IPT-SP, PYR and NC groups had mean birth weights of 3204 +/- 487.16, 3075 +/- 513.24 and 3074 +/- 505.92 respectively (rho < 0.0001). There was a trend towards a lower proportion of low birth weight babies in the IPT-SP group (p = 0.095). CONCLUSION: IPT-SP is effective in preventing maternal and placental malaria as well as improving pregnancy outcomes among parturient women in Ibadan, Nigeria. The implementation of the recently adopted IPT-SP strategy should be pursued with vigour as it holds great promise for reducing the burden of malaria in pregnancy in Nigeria.

The Nigeria wealth distribution and health seeking behaviour: evidence from the 2012 national HIV/AIDS and reproductive health survey.

BACKGROUND: Recently, Nigeria emerged as the largest economy in Africa and the 26th in the world. However, a pertinent question is how this new economic status has impacted on the wealth and health of her citizens. There is a dearth of empirical study on the wealth distribution in Nigeria which could be important in explaining the general disparities in their health seeking behavior. An adequate knowledge of Nigeria wealth distribution will no doubt inform policy makers in their decision making to improve the quality of life of Nigerians. METHOD: This study is a retrospective analysis of the assets of household in Nigeria collected during the 2012 National HIV/AIDS and Reproductive Health Survey (NARHS Plus 2). We used the principal component analysis methods to construct wealth quintiles across households in Nigeria. At 5% significance level, we used ANOVA to determine differences in some health outcomes across the WQs and chi-square test to assess association between WQs and some reproductive health seeking behaviours. RESULT: The wealth quintiles were found to be internally valid and coherent. However, there is a wide gap in the reproductive health seeking behavior of household members across the wealth quintiles with members of households in lower quintiles having lesser likelihood (33.0%) to receive antenatal care than among those in the highest quintiles (91.9%). While only 3% were currently using modern contraceptives in the lowest wealth quintile, it was 17.4% among the highest wealth quintile (p < 0.05). CONCLUSION: The wealth quintiles showed a great disparity in the standard of living of Nigerian households across geo-political zones, states and rural-urban locations which had greatly influenced household health seeking behavior.

Stressors and counseling needs of undergraduate nursing students in Ibadan, Nigeria.

Existing evidence suggests that nursing students have high levels of stress and that counseling and other support services should be made available to them. However, the stressors and counseling needs of undergraduate nursing students in Nigeria have yet to be explored. This study used a questionnaire to investigate the stressors, counseling needs, and desired counseling facilities of undergraduate nursing students at the University of Ibadan. Common stressors included excessive schoolwork, financial problems, inadequate recreational facilities, and overcrowded accommodations. There was an association between reporting inconsiderate, insensitive lecturers as stressors and evidence of psychological distress. Nearly 60% of the respondents felt counseling would help them, and most desired counseling for academics, finances, and relationships. Most (78%) of the respondents preferred an independent facility with trained counselors. Desired characteristics for the services included accessibility, affordability, confidentiality, and a friendly atmosphere. Educators and administrators should use this information to design counseling facilities for students.

Pattern of presentation and survival of breast cancer in a teaching hospital in north Western Nigeria.

OBJECTIVES: Developing countries are experiencing demographic and epidemiologic transition and the prevalence of non-communicable diseases especially cancers which is on the increase. Breast cancer is the most common and lethal malignancy in developing countries with varying presentation. This study aims to determine the pattern of presentation and survival of breast cancer patients in North Western Nigeria. METHODS: A five-year retrospective review of breast cancer records from 2001-2005 was conducted. Relevant information was retrieved and analyzed using statistical package for social science software. Manchester stage III and IV were classified as advance disease. Survival analysis was carried out with survival defined as the time between the date of commencement of treatment and the date of last follow-up or death. RESULTS: Most of the patients were in the 4th and 5th decades 58 (57.4%) with a mean age of 44.5±13 years. Majority of the patients were females 99 (96.1%). One of the four males had invasive lobular carcinoma while the others presented with invasive ductal carcinoma 3 (75.0%). Most of the patients were premenopausal 62 (62.6%) and were presented late with advanced breast cancer disease 64 (62.1%). The left breast was more affected 64 (62.1%), and the upper outer quadrant was mostly involved 48 (60.7%), followed by the areola, 43(41.7%) either singly or in combination. Invasive ductal carcinoma was detected in 85 (82.5%) cases and was the predominant histological finding. Survival rate beyond 30 months was observed in 24.5% of cases and 100% for advanced and early breast cancer respectively, (p=0.0001). The overall survival rate beyond 36 months was 70.4% and postmenopausal patients (70.6%) had better survival beyond 36 months than premenopausal (68.5%) patients (p=0.05). CONCLUSION: The overall survival rate was low and patients with early breast cancer had better survival than those with advanced disease. Majority of the patients were young premenopausal women with advanced breast cancer.