Assessment of delays in receiving delivery care at a tertiary healthcare delivery centre in Nigeria.

This study reviewed the causes of delays when patients were admitted with obstetric emergencies in Ife-Ife, Nigeria.

A study on under five nutritional status and its determinants in a semi-rural community of Ile-Ife, Osun State, Nigeria.

Ten variables were assessed as they influence the under five (U5) nutritional status of children at Oranfe, a semi-rural community in Ife East Local Government Area of Osun state, Nigeria. The two types of protein energy malnutrition (PEM) that are prevalent in the community are stunting and wasting. Of the 230 children assessed using Waterlow's technique, 23% and 22.6% were stunted and wasted respectively. The results confirmed that mothers' educational level, age, parity, types of family and children's immunization status and age are some of the key determinants of nutritional status of U5 children. The intensification of exclusive breast feeding, female education, a compulsory food demonstration unit in all health centres, use of complementary feeds from 7 months upwards, growth monitoring and promotion are some of the strategies to reduce the high prevalence of PEM in both rural and urban areas of developing countries.

Lack of influence of red palm oil on severity of malaria infection in pre-school Nigerian children.

Vitamin A supplements are reported to reduce febrile episodes of malaria and parasite counts, especially in children aged 12-36 months. Red palm oil (RPO) is a good source of vitamin A, is rich in alpha- and beta-carotene and is as effective as high-dose retinyl palmitate supplements in improving vitamin A status. In western Nigeria, where malaria is endemic, RPO is widely used and consumption can be measured using plasma alpha-carotene as a proxy biomarker since there are few other prominent sources of this carotene in the diet. The influence of RPO consumption on malaria was investigated in 207 children (aged 0-60 months) who presented with fever in August-October 1999 at several hospital clinics around Ile-Ife. Medical and anthropometric data, body temperature, parasitaemia and plasma C-reactive protein (CRP), retinol, carotenoids and tocopherols were measured in the children. Mothers were interviewed on usage of cooking oil and mosquito nets in the home, education and occupation. Most families used RPO and median plasma concentrations of both alpha-carotene (0.518 mumol/L) and beta-carotene (0.698 mumol/L) in the children were high. Using body temperature, parasite density and plasma CRP as markers of disease severity, multiple linear regression analysis was carried out on those for whom complete data were available (n = 138), separated into 3 age-groups of < 12 months (n = 37), 12-36 months (n = 68) and > 36 months (n = 33). In the absence of plasma retinol, plasma alpha-carotene explained 13.9% of the variance in parasite density (P = 0.013) but only in children aged > 36 months. The relationship with disease severity was negative, i.e., there was some evidence that RPO usage protected against malaria, and other dietary indices generally indicated that better nutritional status was associated with a lower severity of malaria.

Acceptance of hepatitis B vaccine by workers in a Nigerian teaching hospital.

OBJECTIVES: To determine the pattern of vaccine uptake by hospital personnel in a specifically designed pioneer hepatitis B vaccination programme and to highlight major lessons for ensuring success in future programmes. DESIGN: A review of vaccination and employment records for a forty four-month period and comparative analysis on the basis of professional grouping and work units. SETTING: Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Nigeria. SUBJECTS: A total of 2,548 employees of the teaching hospital that have worked for a minimum of one year on a continuous basis between April 1992 and December 1995. INTERVENTIONS: Procurement of recombinant hepatitis B vaccine (Engerix, SmithKline Beecham) by the hospital management and provision of the same to all interested employees of the teaching hospital at no cost under a vaccination programme which was conducted on an on-site basis. MAIN OUTCOME MEASURES: 'Participation' in the vaccination programme was defined as the uptake of at least one dose of hepatitis B vaccine, and 'compliance' defined as the receipt of the three prescribed doses of the hepatitis B vaccine. RESULTS: The level of participation in the vaccination programme was high with 91.9% of the target population of hospital workers receiving at least a dose of the vaccine, while only about half (53.8%) of the group complied with receiving the required three doses of the vaccine. In terms of participation, by professional grouping, laboratory workers and nurses recorded the lowest rates (82.5% and 84% respectively), while 100% participation was recorded in respect of the staff of engineering, medical records, pharmacy and physiotherapy departments. The highest rate of compliance (receipt of three doses) was also found among non-clinical workers (medical record personnel--76.3% and engineering staff--69.5%) while the lowest rate was found among nurses (39.7%) and doctors (40.3%). CONCLUSION: Workers with the highest possibility of knowledge of, and exposure to hepatitis B infection within the hospital setting--doctors, nurses, and laboratory workers--showed the greatest apathy to the vaccination programme. Reasons for this trend demand close examination, and subsequently, identification of specific action that needs to be taken to improve the uptake of the vaccine by the target population, particularly the high-risk groups, in future programmes. Among others, targeting all groups of workers with appropriate education on the infection; active involvement of professional groups in the planning and execution of the vaccination programme; and review of the implementation logistics are some of the key points to note for future programmes.