Antenatal Care Utilisation among Adolescent Mothers in Ngozi Province, Burundi.

Background: Globally pregnancy and childbirth complications are the leading cause of death among adolescents, with evidence showing that antenatal care (ANC) is a very effective preventive intervention. In Burundi, there is limited information on the extent to which pregnant adolescents utilise such services. Objective: To assess the ANC utilisation and factors associated with its use among adolescent mothers in Ngozi Province, Burundi. Materials and Methods: A cross-sectional, health facility-based study among 216 adolescent mothers who had given birth within two years preceding this study, using structured questionnaires and records from previous ANC booklets. A multistage random sampling technique was used to select respondents while the utilisation of ANC was determined by the frequency of ANC visits and the time when the women enrolled for the first ANC visit. Results: The majority (98.1%) of adolescent mothers in Ngozi Province used ANC services. Most respondents (64.8%) initiated ANC services within the first trimester while 57.8% attained the minimum of four recommended ANC visits. Marital status (P = 0.001), geographical location (P = 0.009), occupation of the partner (P = 0.002) and type of the last pregnancy (P = 0.012) were associated with ANC initiation within the first trimester while marital status (P < 0.001), respondent's employment (P = 0.003) and type of last pregnancy (P < 0.001) were associated with appropriate ANC frequency. Conclusion: This study revealed a high use of ANC services among adolescent mothers, although more than one-third attended ANC late. There is therefore the need to put more effort into improving early booking for ANC.

Risk Assessment Score and Chi-Square Automatic Interaction Detection Algorithm for Hypertension Among Africans: Models From the SIREN Study.

BACKGROUND: This study aimed to develop a risk-scoring model for hypertension among Africans. METHODS: In this study, 4413 stroke-free controls were used to develop the risk-scoring model for hypertension. Logistic regression models were applied to 13 risk factors. We randomly split the dataset into training and testing data at a ratio of 80:20. Constant and standardized weights were assigned to factors significantly associated with hypertension in the regression model to develop a probability risk score on a scale of 0 to 1 using a logistic regression model. The model accuracy was assessed to estimate the cutoff score for discriminating hypertensives. RESULTS: Mean age was 59.9±13.3 years, 56.0% were hypertensives, and 8 factors, including diabetes, age ≥65 years, higher waist circumference, (BMI) ≥30 kg/m2, lack of formal education, living in urban residence, family history of cardiovascular diseases, and dyslipidemia use were associated with hypertension. Cohen κ was maximal at ≥0.28, and a total probability risk score of ≥0.60 was adopted for both statistical weighting for risk quantification of hypertension in both datasets. The probability risk score presented a good performance-receiver operating characteristic: 64% (95% CI, 61.0-68.0), a sensitivity of 55.1%, specificity of 71.5%, positive predicted value of 70.9%, and negative predicted value of 55.8%, in the test dataset. Similarly, decision tree had a predictive accuracy of 67.7% (95% CI, 66.1-69.3) for the training set and 64.6% (95% CI, 61.0-68.0) for the testing dataset. CONCLUSIONS: The novel risk-scoring model discriminated hypertensives with good accuracy and will be helpful in the early identification of community-based Africans vulnerable to hypertension for its primary prevention.

Gender and educational attainment influence willingness to donate organs among older Nigerians: a questionnaire survey.

INTRODUCTION: disparity between the demand for and the supply of organs for transplantation remains a major public health issue of global concern. This study evaluated the knowledge and determinants of willingness to donate organs among outpatient clinic attendees in a Nigerian teaching hospital. METHODS: a 43-item semi-structured interviewer-administered questionnaire was designed to assess awareness and willingness of individuals attending Neurology, Psychiatry and Geriatrics Outpatient clinics to donate bodily organs for transplantation. Association between participants' characteristics and willingness towards organ donation was investigated using logistic regression models. RESULTS: a total of 412 participants were interviewed and mean age was 46.3 (16.1) years. There were 229 (55.6%) females and 92.5% had at least 6 years of formal education. Overall, 330 (80.1%) were aware of donation of at least one organ for transplantation purposes but only 139 (33.7%) were willing to donate organ. In analyses, adjusting for sex, marital status, family setting and educational status, male gender AOR [2.066(1.331-3.2016)] secondary education [AOR 5.57 (1.205-25.729) p= 0.028] and post-secondary education [AOR-6.98 (1.537-31.702) p= 0.012 were independently associated with willingness towards organ donation. CONCLUSION: the survey revealed high level of awareness but poor willingness towards organ donation among older Nigerians attending outpatient clinics of a premier tertiary hospital. Male gender and educational attainment were significantly associated with willingness to donate. Educational programs that particularly target women and less educated older Nigerians are needed to promote organ donation in Nigeria.

Stroke Investigative Research and Education Network: Community Engagement and Outreach Within Phenomics Core.

Stroke is the leading cause of neurological hospital admissions in sub-Saharan Africa (SSA) and the second leading cause of death globally. The Stroke Investigative Research and Education Network seeks to comprehensively characterize the genomic, sociocultural, economic, and behavioral risk factors for stroke and to build effective teams for research to address and decrease the burden of stroke and other noncommunicable diseases in SSA. One of the first steps to address this goal is to effectively engage the communities that suffer the high burden of disease. The purpose of this article is to describe plans to elucidate information about knowledge, attitudes, beliefs, and practices about stroke and genomics from patients, caregivers, and local leaders, to recruit participation in research activities and dissemination of ongoing results, as well as to facilitate research uptake and impact within the broader communities of scientists, health professionals, policy makers, and others. We describe the (a) study sites and their communities; (b) plans for community advisory boards, focus groups, and surveys; (c) methods for data management in REDCap database; (d) analyses of qualitative data; (e) evaluation of community and public engagement across multiple sites and research teams in SSA and the United States; (f) use of RE-AIM for presentation of evaluation data; and (g) community indicators of success. This is the first of its kind public outreach engagement initiative to evaluate stroke and genomics in SSA, and has implications as a model for assessment in other high-stroke risk populations.

Influence of internet exposure on sexual behaviour of young persons in an urban district of Southwest Nigeria.

INTRODUCTION: The proportion of young people exposed to pornographic materials through the internet in Nigeria is increasing. However, the influence of the exposure on their sexual behaviour has not been fully explored. This study therefore explored the effects of internet exposure on the sexual behaviour of young persons in Ibadan North Local Government Area of southwest Nigeria. METHODS: A survey of 413 young persons was done using a pretested self-administered questionnaire which included questions on internet exposure and its influence on behaviour. Data were analysed using descriptive statistics, Chi-square test and logistic regression. RESULTS: Mean age of males was 21.7 ± 3.4 years while that of females was 20.9 ± 3.2 years. Forty-nine percent of the respondents used the internet for the first time between the ages of 15-19 years. Main source of information about the internet was friends (63.3%) and 99.3% accessed the internet from cybercafé. Seventy-two percent had ever stumbled on pornographic sites. Reactions included glancing through before closing (45.2%), closure of the sites (38.5%), and minimizing page to view later (12.5%). Post-exposure influence on behaviour included engagement in oral sex (48.3%), body tattoo (18.3%), having multiple sexual partners (11.6%) and homosexuality (5.0%). More males (95% CI OR =1.245-6.465) and frequent users (95% CI OR =1.168-3.497) were likely to report a change in sexual behaviour. CONCLUSION: Internet use was common among the young persons. Interventions aimed at reducing exposure to sexual content on internet targeting young persons especially the males and cybercafé operators are advocated.

Perception and utilization of cervical cancer screening services among female nurses in University College Hospital, Ibadan, Nigeria.

BACKGROUND: Cervical Cancer (CC) is the second most common cancer among women with early detection and prompt treatment as best management options. Female nurses have crucial roles to play in promoting the utilization of Cervical Cancer Screening Services (CCSS), yet little information exist regarding their perception and utilization of these services. The CCSS related knowledge, perception and utilization among female nurses at the University College Hospital, (UCH) Ibadan, Nigeria were therefore determined. METHODS: A survey of 503 consenting nurses was done using a pretested self-administered questionnaire which included a 40-point knowledge scale and questions on perception of CC. Data were analyzed using descriptive statistics, Chi-square test, ANOVA and logistic regression. RESULTS: Respondents' mean age was 38.0 ± 8.6 years, mean year of experience was 12.5 ± 8.9 years and overall mean knowledge score was 22.8±4.1. Mean knowledge scores by cadre were Assistant Directors (26.7 ± 1.5), Chief Nursing Officers (23.4 ± 2.3) and Staff Nurses (21.7 ± 5.3) (p<0.05). Eighty-eight percent correctly perceived CC to be preventable and 82.0% believed that screening should be carried out as soon as sexual intercourse starts irrespective of age. Only 32.6% had ever used CCSS facility and main reasons for non-use included lack of time (50.8%), fear of result (13.9%) and not being sexually active (6.3%). Staff Nurses were four times less likely to utilize cervical screening services than the Assistant Directors of Nursing (OR 0.23, CI 0.117-0.442). CONCLUSION: Utilization of cervical cancer screening services among the female nurses was poor. Strategies that encourage utilization are hereby advocated.