Alcohol use patterns and hypertension among adults in the United States: findings from the 2015-2016 NHANES data.

OBJECTIVES: This study assessed the association between alcohol use patterns and the prevalence of hypertension. STUDY DESIGN: Data on alcohol use patterns and hypertension among 5918 adults from the 2015-2016 National Health and Nutrition Examination Survey was used for this study. METHODS: The association of alcohol use patterns; "ever-used alcohol", "binge drinking", "heavy drinking", and "everyday alcohol use" with hypertension were assessed using multivariable-adjusted logistic regression to estimate the adjusted odds ratio (aOR) and 95% confidence interval (CI) at a two-sided P < 0.05. RESULTS: Overall, the mean age of respondents was 48.3 ± 18.5 years, 50.9% (n = 3034) were women, and 44.6% (n = 2132) were hypertensive. Also, 85.9% (n = 4177) had used alcohol in their lifetime, 51.9% (n = 1764) were heavy drinkers, 25.1% (n = 370) engaged in binge drinking, and 17.7% (n = 721) reported everyday alcohol use. Compared to those that have never used alcohol, the aOR (95%CI) of stage II hypertension was 1.570 (1.565, 1.575) for overall alcohol use, 1.370 (1.367, 1.373) for everyday alcohol use, 1.127 (1.125, 1.129) for heavy drinking, and 1.092 (1.087, 1.098) for binge drinking. Among current active smokers, the aOR (95%CI) of stage II hypertension was aggravated for everyday alcohol use; 2.583 (2.576, 2.590). CONCLUSION: Alcohol use patterns were associated with a higher prevalence of hypertension, particularly among smokers. A population-based longitudinal study should clarify whether these alcohol use phenotypes are predictive of hypertension at the population level in the United States.

Resumption of Sexual Intercourse and Family Planning use Among Postpartum Women Attending Infant Welfare Clinics in Ibadan, Southwest Nigeria - A Cross-Sectional Study.

BACKGROUND: Women may resume sexual intercourse anytime during the postpartum period with little consideration for contraceptive. AIM: To determine factors associated with resumption of sexual activity, explore FP practices and influence on sexual resumption among postpartum women. SUBJECT AND METHODS: A cross-sectional study of postpartum women at the infant-welfare clinic of Adeoyo Maternity Teaching Hospital and University College Hospital, Ibadan between July and October, 2014. Data on socio-demographic characteristics, contraceptive use, and sexual behavior were collected using interviewer-administered semi-structured questionnaires. Associations were tested using Chi-square tests and Logistic regression analysis for crude and adjusted odds ratios. Level of significance was 5%. RESULTS: There were 256 women with mean age of 29.1 years(SD = 5.2). Majority had tertiary education; were currently married in monogamous marriages and had 1-3 children. Ninety-one(38.7%) had started sexual intercourse at the time of interview. Among those who had not started having sex, about a quarter (24.2%) gave no reason and 20% felt it was too early. The fear of pain and child-spacing were reasons given by 5.7% and 5.1% respectively. Current use of contraceptive method was 20.7% among women and 36.4% among women who had resumed sexual activity. On multiple logistic regression, Family-planning users were about five times more-likely than non-users to resume sexual intercourse (Odd Ratio = 5.66, 95% Confidence interval = 2.61 - 12.28). CONCLUSION: Women commonly resume sexual intercourse during postpartum period without contraceptive use. Interventions during antenatal and early postnatal periods are needed to improve early adoption of Family planning by postpartum women.

Trends in Mortality and Clinical Characteristics of Hospitalized Hiv/Aids Patients at the University College Hospital, Ibadan 2010 to 2016.

OBJECTIVE: The purpose of this study was to examine trends in clinical characteristics and in-hospital mortality of HIV patients in a low resource setting in the period 2010 to 2016. METHODS: Data on socio-demographic and clinical characteristics of 313 hospitalized HIV positive patients at the University College Hospital, Ibadan, Nigeria were retrospectively extracted, described and examined for trends. Factors independently associated with mortality were identified using multiple logistic regression. RESULTS: The mean age was 39 years (SD = 9.8) and about two thirds were female. The proportion of females decreased significantly from 83.3% in 2010-2011 to 39.8% in 2016. There was a significant reduction in the diagnosis of disseminated tuberculosis and mortality from 19.4% and 42.9% in 2010-2011 to 4.8% and 27.9% in 2016 respectively. On multiple logistic regression, being male, having neurological features, meningitis, and shorter stay in hospital had significantly higher odds of mortality. CONCLUSION: There was a reduction in in-hospital mortality of HIV patients over the period from 2010 to 2016. Being male and presence of neurological features were associated with mortality. Larger prospective studies are needed to further investigate this observed reduction in mortality among hospitalised patients.

Patients' Perception of Quality of Diabetes Care Received in Ibadan, Nigeria.

Diabetes Mellitus (DM) is one of the diseases of public health concerns of the 21st century with rising burden in developing countries. The evaluation of care for diabetes from patients' perspective an important indicator of measuring quality of health services and improving treatment approaches but data of the nature are scarce in Nigeria. The study therefore investigated Patients' Evaluation of the Quality of Diabetes care (PEQD) in Ibadan. This descriptive cross-sectional study recruited 384 diabetic patients from three hospitals where specialised services are offered in Ibadan. A semi-structured pre-tested questionnaire was used to collect data. A 42-point PEQD questionnaire scale was used to collect data and a score of >21 was rated as good Perceived Quality of Care (PQC). Data were analysed using descriptive statistics, chi-square test and logistic regression set at 5% level of statistical significance. Mean age of respondents was 62.5 + 10.8 years and mean diabetes duration was 8.4 + 7.6. Majority (58.3%) of the respondents didn't know the type of diabetes they had. Patients aged less than 60 years were less likely to PQC received as good (OR: 0.21; CI: 0.05 - 0.91) compared to those who were above 60 years. More than half (55.0%) of the respondents perceive quality of care as good. Patients' assessment of the quality of diabetes care received was perceived good. There is need to sustain current satisfactory services in diabetic care and institutionalize periodic survey patients' satisfaction to provide feedback for future quality improvement.

Treatment Satisfaction and Medication Adherence Among Hypertensive Patients Seeking Care in Selected Hospitals in Ibadan, Nigeria.

Poor adherence to hypertension treatment is a major health-related problem, and a significant risk factor for complications, disability and hypertension associated mortality. There is a paucity of evidence on the impact of treatment satisfaction on medication adherence among hypertensive patients in Nigeria. This study aimed to determine the association between treatment satisfaction and medication adherence among hypertensive patients in Ibadan, Nigeria. A descriptive cross-sectional study was conducted, wherein hypertensive patients were consecutively recruited from 5 hospitals in Ibadan, Nigeria. A pre-tested, interviewer-administered questionnaire was used to collect data. Medication adherence was assessed using the 8-item Morisky Medication Adherence Scale (MMAS-8), and treatment satisfaction using the 9-item Treatment Satisfaction Questionnaire for Medication (TSQM). Descriptive statistics were computed for all variables. Bivariate analysis was carried out using chi-square test, and multivariate analysis using binary logistic regression. Sensitivity analysis was conducted to adjust for unmeasured binary confounders. Statistical significance was set at p < 0.05 for a 2-tailed. A total of 342 respondents with the mean age of 59.6 ± 12.6 years participated in the study. The overall prevalence of medication adherence was 35.1% (MMAS-8 scores = 8). Treatment satisfaction (AOR=2.03, 95% CI: 1.21-3.43) was independently associated with medication adherence. Sensitivity analysis revealed that the observed association between treatment satisfaction and medication adherence was unlikely to be due to unmeasured confounding variables. Medication adherence was low, and treatment satisfaction independently increases medication adherence. Treatment satisfaction strategies should be part of any treatment intervention packages in this population.

Pneumococcal-specific IgG levels after 13-valent pneumococcal conjugate vaccination in Nigerian children with sickle cell disease.

BACKGROUND: Children with sickle cell disease (SCD) are particularly susceptible to pneumococcal infection. Administration of the 13-valent conjugate pneumococcal vaccine which is now available in Nigeria may help to reduce the incidence. OBJECTIVES: To determine the serum level of pneumococcal-specific IgG (PIgG) in a cohort of patients with SCD after administration of a single-dose of a 13-valent pneumococcal conjugate vaccine. METHODS: The study was conducted between December 2011 and March 2012 among children with SCD aged 5 months to 5 years attending the sickle cell clinic in five public hospitals in Lagos. Altogether, 151 children with SCD and 52 without it (controls) were recruited by convenience sampling from the sickle cell clinics and well-child clinics. Blood samples were collected for PIgG concentrations before and 2 months after a single dose of the Prevenar 13 vaccine. Seroconversion was defined as a fourfold or greater increase in antibody concentration after vaccination while those with PIgG concentrations ≥200 µU/ml were considered to have protective levels. RESULTS: The age range of the total study group was 5-60 months with a mean (SD) of 39.04 (15.44) months and a median of 39 months. The mean (SD) ages of subjects with and without SCD were 38.91 (15.75) months and 16.39 (15.45) months, respectively. The PIgG concentration 2 months post-vaccination was significantly greater than the pre-vaccination levels in all age categories in both groups and almost all subjects had protective PIgG concentrations 2 months after vaccination. A four-fold increase in PIgG concentration was detected more commonly in the controls than in SCD patients. CONCLUSION: Prevenar 13 provided protective immunity in all vaccinated children but those under 2 years of age who had non-protective levels pre-vaccination benefited the most.

Household survey on Human Papilloma Virus vaccine awareness among women of reproductive age in Ibadan, Nigeria.

BACKGROUND: Cervical cancer is the commonest female genital tract malignancy associated with high mortality in sub-Saharan Africa due to poor prevention plan. Human Papilloma Virus (HPV) is a necessary cause of cervical cancer, and the infection is vaccine preventable. Since the introduction of HPV vaccine, robust community surveys on awareness of the vaccine that capture end-users perspective is scarce. The aim of this study is to determine HPV vaccine awareness among women of reproductive age group. METHODS: This was a household survey that used multi-stage random sampling conducted amongst 1002 women aged 18-49 years from August to September 2012 in Mokola area, Ibadan, south western Nigeria. A self-administered pre-tested questionnaire was used for data collection. Descriptive, bivariate and multivariable analyses were performed, and statistical significance was set at 95% confidence level. RESULTS: The mean age was 29.8 +/- 8.2 years and 49.9% had female children. Only 4.6% had heard of HPV vaccine. A significantly higher odds of HPV vaccine awareness was found among highly skilled women, those initiating sexual intercourse at older ages; women with multiple sexual partners and those aware that cervical cancer is preventable. CONCLUSION: The awareness of HPV vaccine is low. Policies and programs that will improve awareness utilising culturally sensitive messages are imperative.

Perceived aetiological factors of folliculitis keloidalis nuchae (acne keloidalis) and treatment options among Nigerian men.

BACKGROUND: Folliculitis keloidalis nuchae (FKN) also known as acne keloidalis is the commonest form of scarring alopecia occurring in African males. It occurs mostly in individuals of African descent. Its prevalence ranges from 1·6% to 16·1%. FKN is multifactorial in origin: androgens, inflammation, trauma, ingrowing hairs and secondary infection have all been implicated in its aetiology. The reason for its occurrence in the occipital region is unclear although elevated androgens in the scalp have been suggested. The occurrence of huge keloidal-like scars in the affected area has earned the name 'Bumps' in this environment. OBJECTIVES: To look at the community's perception of the aetiological factors for bumps and perceived management options available in our environment. METHODS: A community study was carried out among 1003 men residing in an urban community in Mokola, Ibadan, Oyo State, Nigeria. Data on sociodemographic characteristics, knowledge about aetiology, and prevalence of shaving bumps was obtained using a semi-structured questionnaire administered by trained interviewers. The chi-squared test was used to test the associations between presence of FKN and variables. RESULTS: The mean age of the respondents was 31·6 (SD = 8) years. When asked about the cause of shaving bumps, 420 (41·9%) felt it was due to infection from barber's instruments, followed by heredity (110, 11%), poor shaving technique (81, 8·1%), cuts from shaving (52, 5·2%) and inadequate after shaving care (39, 3·9%). The prevalence of shaving bumps was 2·7%. The most commonly reported symptom among those with shaving bumps was itching (71·1%). Other symptoms include pain (9·6%) and bleeding (1·2%). Most of the patients (70·8%) who had ever had shaving bumps practised self-medication. Medications applied included oral and topical antibiotics (20·3%), Neo-medrol (10·9%), engine oil (9·4%) and traditional leaves (9·4%). CONCLUSIONS: About 50% of the responders believed FKN was an infective disorder. Although bleeding occurred while having a haircut, some individuals did not have their own personal shaving kits. Antibiotics, topical steroids, herbs and caustic substances were used for treatment. There is an urgent need to stimulate safer hair shaving practices and discourage the wrong treatment of FKN.

KNOWLEDGE, ATTITUDE AND CONTROL PRACTICES OF SICKLE CELL DISEASE AMONG YOUTH CORPS MEMBERS IN BENIN CITY, NIGERIA.

BACKGROUND: Sickle cell disease (SCD) is a major public health problem in Nigeria. Carrier prevalence is about 25% and it affects about 2 - 3% of the Nigerian population. The disease runs a chronic course, characterized by recurrent ill-health, progressive organ damage and shortened life-span. There is a need for SCD control through public education and other preventive measures. OBJECTIVE: This study aimed at assessing the level of knowledge regarding SCD among a cross-section of new tertiary graduates in Nigeria, as well as factors influencing their knowledge. It also describes their attitudes and patterns of control practices engaged by the respondents regarding SCD. METHOD: This was an analytic, cross-sectional study among 370 new tertiary graduates (youth corps members) in Benin City, Nigeria. Bio-data, data on knowledge, their attitude and control practices of sickle cell disease were obtained using a structured questionnaire. Association between the mean level of knowledge and other variables such as age, gender, course of study, etc were tested using one way analysis of variance. RESULTS: Most of the study participants were aged 22 - 29 years. A large proportion (63.5%) of the respondents was females. Only 17.8% of the respondents had a good knowledge of SCD despite high level of awareness (98.4%). Those who studied courses related to medical sciences had significantly higher mean knowledge score. About 94.6% of the respondents knew their SCD carrier status and 80.8% were willing to avoid carrier marriages. Only 38.1% will accept prenatal diagnosis/selective abortion if locally available. CONCLUSION: Most participants demonstrated moderate level of public health knowledge regarding SCD in Nigeria. Considering the relative lack of prenatal diagnostic services, low acceptability of selective abortion among the respondents, sub-optimal care of affected persons and poor access to haemopoeitic stem cell transplantation (HSCT) in our environment, stronger efforts should be directed and sustained at primary prevention through public education and screening regarding SCD.

Knowledge and use of emergency contraception by medical doctors on internship in a tertiary healthcare facility in Nigeria.

CONTEXT: Emergency contraception (EC) is widely used to prevent unwanted pregnancy and it is largely adopted in many countries as over the counter drug to improve access. AIMS: To determine and compare the correct knowledge, attitude and current use of EC among newly graduated medical doctors (MDs). SETTINGS AND DESIGN: A cross-sectional study conducted among 255 newly graduated MDs at the University College Hospital, Ibadan, Nigeria. MATERIALS AND METHODS: A pretested self-administered questionnaire was used to obtain data from consenting participants. STATISTICAL ANALYSIS USED: Descriptive, bivariate, and multivariable analyses were performed, and statistical significance was set at 0.05. Statistical Package for Social Science version 15.0 (Chicago, IL, USA) software was used. RESULTS: The mean age of the respondents was 27.2 years (standard deviation = 2.1). The commonest indication for emergency contraceptive use mentioned was rape-96.5%. About 70% support EC in Nigeria, while about a quarter (26.9%) routinely counsel women about ECP use. About 21% of respondents currently use EC. Logistic regression analysis revealed significant results for gender [odds ratio (OR) =3.64; 95% confidence interval (CI) OR = 1.31-10.01), religion (OR = 0.26; 95% CI OR = 0.11-0.630) and marital status (OR = 0.19; 95% CI = 0.07-0.56). CONCLUSION: The correct knowledge and professional disposition toward EC as a form of contraception is low. We recommend that in-service training should focus more on EC to improve the quality of their knowledge and attitude towards it.

Prevalence and correlates of mental health problems among awaiting trial inmates in a Prison facility in Ibadan, Nigeria.

INTRODUCTION: Prevalence of mental health problems are frequently higher within the prison populations than the general population. Previous studies of prison mental health had focused on convict populations whereas, the awaiting trial segment of the prison population in Nigeria has gradually become the majority of the total lock-up. This study aimed to evaluate the prevalence and correlates of mental health problems among the awaiting trial inmates in a prison facility in Ibadan. METHODS: A cross sectional study design was employed to interview 725 awaiting trial inmates of Agodi Prison, Ibadan, Nigeria. A two phase procedure was utilized with initial screening using a socio-demographic questionnaire and the General Health Questionnaire (GHQ -12); followed by a second phase with all high scorers on the GHQ -12 and 10% of the low scorers using the MINI International Neuropsychiatric Inventory (MINI). RESULTS: A total of 394 respondents participated in the second phase of the study with a mean age of 31.1 years (SD = 8.7), with ages ranging from 18 - 70 years. The mean duration of incarceration at Agodi was 1.1 years (SD = 1.47), with a range of 1 week to 10 years. The prevalence of mental illness was 56.6% with the commonest conditions being depression (20.8%), alcohol dependence (20.6%), substance dependence (20.1%), suicidality (19.8%) and antisocial personality disorder (18%). CONCLUSION: There is a high prevalence of neuropsychiatric disorders among awaiting trial inmates but this does not appear to be significantly different from that of convict populations.

Cervical ripening and induction of labour-awareness, knowledge and perception of antenatal attendees in Ibadan, Nigeria.

The levels of awareness, knowledge and the perceptions of women about cervical ripening and induction of labour were assessed in a cross-sectional questionnaire-based interview of 265 antenatal attendees of the University College Hospital, Ibadan, Nigeria from 1 March to 30 April 2009. Questions included evaluated sociodemographic data, obstetric history, awareness of both procedures and knowledge of specific methods. Data analysis was done using SPSS v.14.0 for Windows; frequency tables were utilised to determine proportions and significant variables from χ(2) analysis were entered into a logistic regression model. The majority of respondents were between 26 and 34 years; 56.4% were nulliparous. Awareness of cervical ripening and induction of labour was found in 71% of respondents. Knowledge of misoprostol and Foley's catheter however, was present in 25% and 13% of all women, respectively. Both procedures were perceived to prevent caesarean section or reduce burden of health workers in 16% of respondents. No significant predictor of knowledge was found but history of previous induction was a predictor of awareness (p < 0.05). Improved counselling is required to further increase knowledge of methods for induction and correct wrong perceptions, particularly in women at risk of labour induction.

Mammographic breast pattern in Nigerian women in Ibadan, Nigeria.

INTRODUCTION: Mammographic breast density is dependent on the relative proportion of radiolucent fat and radio-dense connective and glandular tissue. This breast density is said to be a marker of risk for breast cancer and has received widespread interest in many countries in recent years. AIMS AND OBJECTIVES: The main objective of this study is to estimate the prevalence of the various mammographic breast density patterns and seeks to find any association between the reported breast patterns and various demographic variables in women in Ibadan, South West Nigeria. METHODS: A prospective descriptive study of mammographic breast pattern in 498 women at the Department of Radiology, University College Hospital Ibadan. Two screening views and additional views when necessary were done on each breast with the Senographe DMR+ Mammographic Unit. Participants also completed an assisted administered questionnaire which was used to obtain data on their socio-demographic characteristics. RESULTS: The study confirmed significant association with age and parity as in previous reports in the diaspora. CONCLUSION: The study confirmed denser mammographic breast pattern in younger and nulliparous women. Future work on mammographic density and other variables is contemplated for complete cancer related data in our peculiar setting.

Cost of epilepsy in children attending a tertiary centre in Nigeria.

Epilepsy is one of the leading paediatric neurological disorders in Nigeria and many other parts of the world. There is very little documented on the economic costs of epilepsy in Nigeria and other countries in sub-Saharan Africa. This study was carried out to estimate the total cost of childhood epilepsy in a cohort of Nigerian children and therefore provide essential information on the economic burden of childhood epilepsy in Nigeria. A cost of illness study was performed on a cohort of 215 consecutive cases of epilepsy seen and treated at the University College Hospital, Ibadan, Nigeria. Data on demographics, clinical characteristics, utilization of resources and costs were collected. The total annual cost of epilepsy ranged from Nigerian naira (N)23 200 (US$155) to N3 298 500 (US$21,900) with a median of N107 600 (US$717) per patient per year. Direct medical and non-medical costs accounted for 71.8% of the total mean annual cost of epilepsy. Anti-epileptic drug therapy and in-patient care accounted for 21.8% and 33.0% of the mean total annual cost respectively and more than half of the families expended over 20% of their total family income on the care of the child with epilepsy. The economic burden of childhood epilepsy in Nigeria is enormous with very high out-of-pocket expenses.

Seroprevalence of bovine brucellosis in trade cattle slaughtered in Ibadan, Nigeria, from 2004-2006.

A seroprevalence study was carried out among trade cattle slaughtered at Bodija Municipal Abattoir, Ibadan (southwestern Nigeria) over a period of 3 consecutive years from 2004 to 2006 with a view to determining the breed, sex and age distribution in the seropositivity of bovine brucellosis. In total, 1642 animals were examined for antibodies to Brucella abortus using the Rose Bengal test. Seroprevalences of 6.00%, 6.17% and 5.31% were obtained in the years 2004, 2005 and 2006, respectively but a decrease in 2006 shows no significant difference (P > 0.05). The role of the breed (P > 0.05), sex (P > 0.05) and age (P > 0.05) in the occurrence of the infection was not statistically significant at 5%, although higher rates were obtained for females and older animals. The trend in the disease over the 3-year period showed that it is endemic in trade cattle slaughtered in Ibadan and the public health implications of this are discussed.

Children not receiving adequate immunization in Ibadan, Nigeria: what reasons and beliefs do their mothers have?

BACKGROUND: Immunization coverage in most areas in Nigeria has remained low with continued high morbidity and mortality from vaccine preventable diseases. OBJECTIVES: To identify the reasons and beliefs about immunization among mothers whose children have not received adequate immunization or not at all. SUBJECTS AND METHODS: The study was a descriptive cross sectional survey that involved mothers trading in a large market in Ibadan who had children between the ages of 12 and 23 months. Data were collected by means of a semi-structured questionnaire. Mothers who did not immunize or failed to completely immunize their children were selected for analysis. RESULTS: A total of 248 mothers were interviewed, their mean age was 27.3 5.5 years (range 16 42 yrs). The commonest reasons for incomplete immunization included: non availability of vaccines (26.2%), not being aware of need for additional doses (16.5%) and inconvenient time/venue (13.7%). Logistic regression analysis showed that Mothers with no formal education were about six times more likely than those with secondary education and higher to give reasons related to lack of motivation (95% CI OR = 1.88 17.93). Analysis of the mothers' beliefs on immunization were as follows; 186 (75.0%) believed it was beneficial, 161 (64.9%) believed that immunization will save the life of the child and 129 (52.0%) believed that taking the child to the clinic for immunization wasted a lot oftime. CONCLUSION: Most mothers in this study agreed that immunization is beneficial. It is therefore recommended that routine immunization be strengthened, vaccines made readily available and mothers educated on the immunization schedule.

Human immuno-deficiency virus and hepatitis B virus coinfection in pregnancy at the University College Hospital, Ibadan.

Human Immuno-deficiency virus (HIV) and Hepatitis B Virus (HBV) share common modes of transmission which include blood borne and the vertical routes. Although, the natural course of HIV does not appear altered by HBV, the rate of liver-related deaths is several times higher among HIV/HBV co-infected persons. Clinicians providing care for HIV positive individuals, including pregnant women, need to be aware of this problem. This is a 2-year cross-sectional study that commenced in January 2006, among HIV positive pregnant women seen at the University College Hospital, Ibadan. During the study period, 721 HIV positive pregnant women were screened for hepatitis B virus infection. Sixty-four women (8.9%) were positive for HBsAg, 14(1.9%) were HCV positive and 642 (89.2%) were negative for both HBV and HCV. One patient was positive forboth HBV and HCV. There were no remarkable differences between HIV infected and HIV-HBV coinfected patients in terms of the hematological, albumin and bilirubin measurements. Alanine transaminase was however higher in the HIV-HBV co-infected patients than HIV patients and this was statistically significant (17.5 iu/ ml vs. 15.0 iu/ml, p value--0.009). In addition, the CD4 cell count was lower and the viral load marginally higher in the hepatitis B virus positive patients. The differences were however not statistically significant (p value--0.114 and 0.644 respectively). HIV-HBV co-infection in HIV positive pregnant women is not of negligible proportions as demonstrated in this study. Thus, HIV positive pregnant women should be screened for HBV and assisted to access care targeted at preventing morbidity and vertical transmission.

Immunization status and its determinants among children of female traders in Ibadan, South-Western Nigeria.

Traders form a large percentage of the female work force in Nigeria and may spend long hours at work, thereby putting their children at risk of inadequate immunization. The study assessed primary immunization completion rate and the determinants of immunization status among the children of female market traders in Ibadan, South-Western Nigeria. A cross-sectional community-based survey was carried out in Bodija market among female traders who had children aged 12 to 23 months. The subjects were selected by systematic random sampling and data collected with an interviewer administered semistructured questionnaire. Logistic regression was used to estimate the predictors of incomplete immunization for the socio-demographic variables. A total of418 women were interviewed. Ninety two percent worked > or = 6 days a week and 78.5% had their children with them in the market all the time. Full immunization by both card and history was recorded in only 40.7% while 8.4% children had never been immunized. The highest vaccine coverage was seen with BCG (91.4%) while Hepatitis B (1%) had the lowest coverage. DPT1 to DPT3 vaccine drop out rate was 32.1%. All the immunizations were received in health facilities. The immunization coverage rate among children of female traders was low. Routine immunization sites should be made available in the markets.

Determinants of post-caesarean wound infection at the University College Hospital Ibadan Nigeria.

OBJECTIVE: To determine the risk factors that predispose patients to post-caesarean wound infection at a tertiary health institution in developing country. METHOD: It was an observational study of all women that had caesarean (elective and emergency) delivery between July and September, 2004. The outcome of their post-caesarean wound was assessed. Statistical analysis (Bivariate and logistic regression) of the identified risk factors in patients who developed wound infection was performed at a 95% level of confidence. RESULTS: The post-caesarean wound infection rate was 16.2%. The identified risk factors were lower educational status, multiple pelvic examination, offensive liquor at surgery and patients that are unbooked. Following logistic regression, women with up to primary school were 20 times more likely than those with secondary education and above to develop wound infection (95% CI OR = 1.8 to 250.0). CONCLUSION: The outcome showed that the identified determinants of post-caesarean wound infection were comparable with earlier reports. Women with lower educational status are more at risk in this study. Therefore, these women need special attention to reduce the risk.

Awareness and desirability of labor epidural analgesia: a survey of Nigerian women.

BACKGROUND: Pain relief is an integral part of labor management. Epidural analgesia is the most effective form of pain relief, but in most Nigerian obstetric units it is not available. There is little information on the views of pregnant women about epidural analgesia during labor. METHODS: A cross-sectional survey using a structured questionnaire was conducted in the antenatal clinic of University College Hospital, Ibadan, Nigeria to assess women's views about epidural analgesia. RESULTS: Of the 650 women surveyed, 523 (80.5%) had knowledge of labour pain while only 127 women (19.5%) were aware of epidural analgesia. Knowledge was affected by parity. Awareness of epidural analgesia was related to occupational status (OR 11.00, 95% CI 5.31-22.83) and having previously experienced childbirth on one previous occasion (OR 1.75, 1.05-2.92). A total of 103 (15.8%) respondents wanted to receive epidural analgesia in their next labor. Occupation (P=0.006), knowledge of epidural analgesia (P=0.017) and previous use (P<0.001) significantly influenced desire for epidural analgesia but only knowledge (OR 2.4 95% CI 1.4-4.3) and previous use (OR 5.3 95% CI 2.1-13.5) were of statistical significance on multivariate analysis. CONCLUSION: This study shows that the knowledge of labor epidural analgesia amongst Nigerian women is low. Despite limited availability, women who are aware of epidural analgesia and those who have received it in a previous labor were more likely to want it in their forthcoming labor. Some women may refuse its use despite their knowledge.