Assessing the awareness and acceptability of hepatitis B immunoglobulin among pregnant women in Enugu metropolis, Southeast, Nigeria: A cross-sectional study.

Objectives: Assessed the level of awareness of hepatitis B virus infection and hepatitis B immunoglobulin, and determined the proportion of pregnant women that will accept hepatitis B immunoglobulin if needed for their babies and the factors that were associated with the choices made by pregnant women in the Enugu metropolis. Methods: A cross-sectional study of 379 pregnant women in health facilities in the Enugu metropolis was undertaken between March and November 2019. A structured pre-tested interviewer-administered questionnaire was used for data collection. Data collected were analysed using SPSS version 23. Results: The overall knowledge of the respondents on hepatitis B virus infection was poor as only 26.6% had good knowledge. Only 25.6% of the respondents had heard of hepatitis B immunoglobulin but the majority of the respondents (93.1%) were both willing to accept to give the vaccine to their babies and recommend the vaccine to their relatives. The educational level and occupation of the respondents were significantly associated with overall knowledge of hepatitis B. Only the religion of the respondents correctly predicted the overall knowledge of the respondents on hepatitis B. Conclusion: Despite the poor knowledge of hepatitis B and hepatitis B immunoglobulin among the study participants, the acceptability of hepatitis B immunoglobulin was high.

Clinical Profile of Patients on Highly Active Antiretroviral Therapy (HAART) Seen in a Tertiary Eye Clinic.

Background: Highly active antiretroviral therapy (HAART) is the medication regimen for the management of human immunodeficiency virus. Over time, it has been dubbed to have revolutionised the clinical course and outcomes of HIV/AIDS. Objective: The objective of this study is to determine the clinical factors associated with the ocular manifestation of HIV/AIDS among patients on HAART. Materials and Methods: This was a descriptive cross-sectional study conducted at the ophthalmology department of the University of Nigeria Teaching Hospital (UNTH) in 2017 among adult patients (≥18 years) attending the hospital's antiretroviral therapy (ART) clinic and selected using systematic random sampling technique. Statistical Package for Social Sciences (SPSS) version 21 was used for data analysis, with variables being summarised using frequencies and proportions. Inferential statistics (t test, Chi-square test, and Fisher's exact test) was used to test associations between variables. A level of significance was set at a P value of less than 0.05 corresponding to a 95% confidence interval. Results: A majority of patients were in WHO stages 1 and 2 of HIV and the mean CD4+ cell count of the whole population was 575.0 ± 512.56 cells/µL, while that of those with ocular manifestations was 315.2 ± 290.76 and 633.7 ± 533.54 cells/µL for those who do not have ocular manifestation. There was a significant association between CD4+ cell count and ocular manifestations such as conjunctival microvasculopathy, anterior uveitis, and cytomegalovirus retinitis. Conclusion: Our results suggest that HAART has some positive effect on the clinical profile of people with HIV/AIDS with CD4+ count being a major determinant of ocular manifestations.

Qualitative study of the stigma associated with the lived experiences of Buruli ulcer disease among patients in Nigeria.

BACKGROUND: Buruli ulcer disease (BUD) is a neglected tropical disease of the skin, subcutaneous tissue and bone caused by Mycobacterium ulcerans, with various disabling and stigmatising sequelae. Patients face a range of adverse impacts owing to the disease as most are unable to relate effectively with their communities, battling stigma and fear of discrimination. This study aimed to explore the stigma associated with the lived experiences of BUD in patients in Nigeria. METHODS: This was a cross-sectional qualitative study that employed a focus group discussion (FGD) and key informant interviews in Enugu State, Nigeria. A random sampling of communities was followed by a purposive selection of FGD participants and key informants. A total of six key informants and eight FGD participants took part in the study. Data were collected over 6 wk from December 2022 to February 2023. The NVivo application was used to analyse transcripts and compute themes of quotes. RESULTS: Patients experienced stigma owing to the condition. The most reported experiences by participants were shame and culpability, isolation and social exclusion, including maltreatment from family members. CONCLUSIONS: Identifying the stigma experienced by patients owing to BUD helps in the provision of psychosocial management services and support for patients.

Serum leptin levels and relationship with maternal weight gain at term among obese and non-obese pregnant women in Enugu, Nigeria: a comparative cross-sectional study.

OBJECTIVE: To determine and compare the mean maternal serum leptin levels, the prevalence of high serum leptin levels and mean gestational weight gain at term among obese and non-obese pregnant women in Enugu, Nigeria. METHODS: This cross-sectional comparative study enrolled obese and non-obese pregnant women. The serum leptin levels of the women were determined using an enzyme-linked immunosorbent assay kit. Anthropometric and sociodemographic data were obtained and compared. Mean weight gain during pregnancy was determined. RESULTS: A total of 170 pregnant women were included in the study. The mean ± SD serum leptin level (99.39 ± 50.2 ng/ml) and the prevalence of hyperleptinaemia (81 of 85 patients; 95.3%) among the obese pregnant women at term were significantly higher than those of the non-obese pregnant women (48.98 ± 30.35 ng/ml/65 of 85 patients; 76.5%). The mean percentage weight gain was significantly higher in the non-obese women compared with the obese women at term. The predictors of high maternal serum leptin level at term among the participants were the employment status and levels of education of the participants. CONCLUSION: Maternal serum leptin level, maternal weight gain and prevalence of hyperleptinaemia at term were significantly higher in the obese compared with the non-obese pregnant women.

Radiological Analysis of Cassava Samples From a Coal Mining Area in Enugu State Nigeria.

Cassava holds a vital position as a staple food in Nigeria, forming a significant portion of the daily diet for the population. Unfortunately, food intake can serve as a pathway for radiological contamination in humans and animals. In this study conducted in an old coal mining area in Enugu State, Nigeria, cassava samples from the area were analyzed using gamma ray spectroscopy. The results revealed significant mean activity concentrations of the radionuclides 40K, 226Ra, and 232Th in camp 1, camp 2, and Pottery areas. The activity concentration ranged from 193.68 to 300.92 Bq/kg for 40 K, 23.03 to 37.24 Bq/kg for 226Ra, and 135.33 to 158.43 Bq/kg for 232Th, respectively. Of concern is the total mean annual effective dose resulting from exposure to these 3 observed radionuclides that was calculated to be 2.03 mSv/yr. This value exceeds the recommended limit of 1 mSv/yr, indicating potential health risks associated with the radiological contamination from cassava consumption in this region. In summary, the study shows that cassava samples from the investigated area exhibited elevated levels of radiotoxicity, raising concerns about the safety of consuming cassava from this region as a food source.

Knowledge and acceptance of COVID-19 vaccine among healthcare workers in Enugu metropolis, Enugu state, Nigeria.

Background: COVID-19 disease spread at an alarming rate, and was declared a pandemic within 5 months from the first reported case. As vaccines have become available, there was a global effort to attain about 75% herd immunity through vaccination. There is a need to address the issue of vaccine hesitancy to COVID-19 vaccines especially in places such as Sub-Saharan African countries which have a high rate of background vaccine hesitancy. Objective: To determine the knowledge and acceptance of COVID-19 vaccines among healthcare workers (HCWs) in Enugu metropolis. Methods: A cross-sectional descriptive study of 103 HCWs in Enugu metropolis was done. Data was collected using structured online Google forms. Descriptive and inferential statistics was done using SPSS, and results were summarized into percentages and associations. Results: An acceptance rate of 56.2% was obtained among HCWs in Enugu metropolis. Positive predicators of acceptance include older age (p = 0.004, X2 = 13.161), marriage (p = 0.001, X2 = 13.996), and higher average level of income (p = 0.013, X2 = 10.766) as significant correlations were found. No significant association was found between educational level, religion, denomination nor occupation, and acceptance of vaccine. The major factor responsible for refusal was fear of side-effects. Discussion: The acceptance rate of COVID-19 vaccines among HCWs is still less than optimal. This population represents the most enlightened population on health related matters, hence if acceptance rate remains merely average that in the general population is expected to be worse. There is a need to address the fear of vaccine side-effects by inculcating more open and interactive methods of information dissemination, while also addressing the misconceptions or myths surrounding COVID-19 vaccines.

Assessing Focused Antenatal Care Awareness and Utilization Among Pregnant Women in Enugu State, Nigeria: A Cross-Sectional Survey.

INTRODUCTION: Focused antenatal care (FANC) is a newer and better approach to antenatal care for pregnant women than the traditional model. FANC emphasizes individual assessment and decision-making by both the provider and the pregnant woman, resulting in better health outcomes for both mother and baby. Despite the adoption of FANC care in Nigeria, maternal mortality indices have not significantly decreased. This study aimed to assess the level of awareness and utilization of FANC among pregnant women in Nigeria, as well as the factors that influence its utilization. METHODS: This study was conducted in Enugu, Nigeria, using the antenatal clinics of three major tertiary hospitals. A cross-sectional design was used, and a sample size of 300 pregnant women was selected using systematic random sampling. Data were collected using a structured, self-administered questionnaire and analyzed using IBM Statistical Package for Social Sciences (SPSS) version 26. The findings were presented using frequencies, tables, charts, and figures, and Fisher's exact test was used to determine the relationship between respondents' knowledge of focused antenatal care and their demographic factors. RESULTS: A study involving 300 pregnant women in Nigeria found that only 15% of them had heard of focused antenatal care (FANC) and just 7.3% had good knowledge of its components, which was attributed to the low level of education among the respondents (X2=16.68, p=0.001). Health talks during antenatal visits were the most common source of information on FANC. The study also revealed that late initiation of antenatal care (n=144, 48%) in current pregnancy and (n=106, 54.6%) among those previously pregnant, as well as insufficient attendance, were identified as risk factors for maternal mortality. Long waiting times (n=196, 65.3%) and overcrowded healthcare facilities (n=110, 36.7%) were the major causes of dissatisfaction with antenatal care services among the respondents. Pregnant women preferred delivering at tertiary hospitals or private hospitals due to the perceived better quality of care and personal preference. These findings could inform targeted interventions to improve knowledge and awareness of FANC among pregnant women, particularly those with lower levels of education. CONCLUSION: This study provides important insights into the low awareness and utilization of FANC among pregnant women in Enugu, Nigeria, highlighting the need for targeted interventions to improve knowledge and awareness of FANC. The study's findings have important implications for the development of maternal and child health policies and interventions aimed at improving the utilization of healthcare services during pregnancy and childbirth in Nigeria. Further research that includes qualitative methods could provide more nuanced information on pregnant women's experiences and perspectives on FANC.

An appraisal of the implementation of the national school feeding programme and its effect on enrolment and attendance in public primary schools in Southeast, Nigeria: perception of heads of schools.

INTRODUCTION: The National Home Grown School Feeding Programme (NHGSFP) was re-launched in Nigeria in 2016, eleven years after it was first introduced in the country, with Enugu as one of the beneficiary States. The objectives of the programme are to improve the health of school children and aid in the realization of Universal Basic Education (UBE) goals. This study explored the opinions of heads of public primary schools on the implementation and policy benefits of NHGSFP in Enugu, southeast Nigeria. METHODS: This was a cross-sectional study conducted among 24 headmasters and headmistresses purposively selected from public primary schools in the Enugu metropolis. Qualitative data were collected through the use of a pretested Key Informant Interview (KII) guide, and analyzed using a thematic approach. RESULTS: All the participants were aware of the NHGSFP, which involved the provision of one mid-day meal per child per school day to the pupils, and all their schools were part of the programme. Most of the participants complained about the nutritional quality and quantity of the school meals which they felt were poor. None of the schools had a kitchen within the school premises, and all the participants admitted that deworming was not regularly carried out, as part of the programme. Most of the participants believed that the objectives of the feeding programme, including, reduced hunger among learners, increased school enrolment, attendance and enhanced participatory learning, were being met. CONCLUSION: Although the NHGSFP was implemented in every school in Enugu metropolis, Enugu State, Nigeria, regular deworming of pupils was not carried out, and there were concerns about certain aspects of the implementation, such as inadequate funding and poor quality of school meals. Thus, there is a need for the introduction of deworming and more allocation of funds to the programme to improve the quantity and nutritional quality of school meals.

Awareness and knowledge of risk factors associated with oral cancer among military personnel in Nigeria.

Background: The military lifestyle has been reported to increase the risk of this population group to the development of oral cancer. Aim: This study aimed to determine the awareness and knowledge of oral cancer in a population of soldiers to acquire data for establishing an educational program for units of the Nigerian Army in oral cancer prevention and monitoring. The study was conducted in the dental center of 82 Division Military Hospital, Nigerian Army, Enugu, Nigeria. A cross-sectional survey was performed using a pre-tested self-administered questionnaire. Materials and Methods: Questions relating to oral cancer awareness, knowledge of causes, and relationship to certain habits, treatment options, and desirability of screening opportunities for oral cancer were asked. Soldiers attending the military hospital, dental center, were chosen randomly for the study. Results: Three hundred soldiers were surveyed. The mean age of those surveyed was 37.5 and had spent an average of 11-15 years in the Army. The majority of the soldiers (80.7%) have heard of cancer; the types most known were breast (75%), skin (30%), and lung cancer (28.3%). Of the 300 soldiers surveyed, 15.3% knew about oral cancer, with 41.3% of these able to identify cigarette smoking and (26%) alcohol consumption as possible risk factors associated with oral cancer. The majority believed that cancer was caused by some form of supernatural phenomenon. Conclusion: Oral cancer awareness is low among soldiers in the Nigerian Armed Forces, and strategies to increase awareness should be developed.

Utilization of eye care services in an underserved community in Enugu State, Nigeria.

Background and Aim: To determine the utilization of eye care services in an underserved community in Enugu State, Nigeria. Materials and Methods: A community-based cross-sectional study was conducted among adults aged 18 years and older. A structured questionnaire was used to collect information on the utilization of eye care services within the last two years. Result: A total of 500 adults with a mean age of 48 ± 10 years participated in the study, the majority (65.6%) of whom were females. The utilization rate within the last two years was 18% (40/500). Utilization of eye care services was associated with age, religion, occupation, marital status, monthly income, education, family history, and history of ocular disease (all P < 0.05). The major barrier to the utilization of eye care services was cost (30%), distance (22.6%), and bad road infrastructure (15.2%). Conclusion: There is a low rate of eye care service utilization in the Ugbawka community of Enugu State, Nigeria. The cost of eye care services, distance, and bad road infrastructure were the major barriers to the use of eye care services. These suggest the need for the provision of affordable and accessible eye care services in this community to reduce the burden of visual impairment and blindness.

Presentation weight indices for patients with cleft and non-affected children: A two-centre study.

Background: Children with cleft lip and/or palate (CL/P) face many challenges in the society. They tend to suffer malnutrition and therefore poor weight gain due to lack of standard care, especially from their parents and society at large. The poor weight gain leads to delayed surgical repair of the cleft abnormality leading to prolonged nutritional and psychological challenges for all concerned. Objective: The aim of the study was to determine if children without cleft abnormalities presenting for routine immunisation and children with cleft abnormalities are both likely to be less than the 75th percentile of expected weight at the time of presentation, and if there is any difference in presenting weight amongst children with different cleft types. Materials and Methods: This was a retrospective study. Data of children that attended the immunisation clinic of the Department of Primary Health of the National Orthopaedic Hospital, Enugu, and routine surgical clinic of the National Orthopaedic Hospital, Enugu, Nigeria, and the Good Shepherd Specialist Hospital, Enugu, Nigeria, between January 2010 and December 2014 with a diagnosis of CL/P, were obtained from the medical records. The data were analysed with SPSS and the confidence interval was 95%. Results: A total of 923 medical records were reviewed for the study, out of which 363 were for children with cleft abnormalities. There was no significant difference in the weight of the children without cleft and presenting for routine immunisation compared with their expected 75th percentile, or children with cleft abnormality compared with their expected 75th percentile (either in their first or in their second visits). With the children that presented with CL/P, there was a significant difference noted amongst children with both CL/P deformity with the expected 75th percentile weight, irrespective of whether the combination was unilateral or bilateral, with P = 0.041. This difference was noted in their first visit. Conclusion: Children with combined CL/P are at risk of presenting with poor weight. Nutritional rehabilitation considered early with children with cleft and particularly those children with combined CL/P.

A randomised controlled trial of a cognitive behaviourally informed intervention for changing violent sexual attitudes among adult sexual offenders in prison.

BACKGROUND: Predatory sexual acts by adults cause concern worldwide. Patterns of distorted thinking and weakened self-control are among the leading explanations. Amidst growing concerns about sexual offences in Nigeria, it might be that more psychologically informed interventions in prison could reduce the risks of further harm compared with the standard prison regime. AIMS: To test the effectiveness of a cognitive behaviourally informed intervention (CBII) in reducing violent sexual attitudes among men in prison in Nigeria for a sexual offence. METHODS: In a randomised controlled trial, men in two prisons who responded to in-prison advertising about the trial were screened for nature of offence and willingness to participate. Those nearing their sentence end or in other psychological therapy were excluded. Sample size was confirmed by power calculation. The Compulsive Sexual Behaviour Inventory (CSBI-22) and the Hypersexual Behaviour Inventory (HBI) were administered before, immediately after and 3 months after completion of a 12-session (18 h) Cognitive Behavioural Informed Intervention or equivalent periods of 'treatment as usual' (TAU) alone. The CBII was designed to change sexual attitudes, and delivered by trained cognitive therapists to the men, as a group, in one of the prisons while the controls received only TAU in the other. RESULTS: Before the intervention, the 39 men in each group had similar psychosocial histories and sexual attitude scores. Following CBII, the intervention group showed a significant reduction in scale scores that was sustained, whereas the TAU group showed no significant change in scores. An ANCOVA analysis confirmed between-group differences immediately after the intervention and 3 months later. CONCLUSIONS: This randomised controlled trial adds to existing knowledge in the field because prior studies have been from high income countries, where interventions are generally delivered in more privacy and at greater length. Given that our study had to be limited to change in sexual attitudes as the main outcome, future research must focus on the extent to which such change maps on to changes in interpersonal behaviour among such men. If these findings can be extended in this way and replicated, this could pave the way for more cost-efficient interventions in higher income countries too.

The unique contributions of depression and anxiety to suicidal ideation among Nigerian secondary school students: a cross-sectional survey.

Background: It is important to establish the pattern of suicidal ideation among adolescents with depression and anxiety. This will help the schools prevent possible complete suicide among these groups of adolescents' trough counseling and education. Objectives: This work is therefore aimed at determining the effects of depression and anxiety on adolescent suicide ideation and factors that predict suicidal ideation among adolescents attending secondary school in southeast Nigeria. Methods: A cross-sectional study among 450 secondary school adolescents in Enugu state, Nigeria. Information was obtained using the Columbia suicide severity rating scale and the Hospital Anxiety and Depression Scale (HADS). Chi-square test, correlation analysis and Hierarchical logistic regression were used in the analysis, and the level of statistical significance was determined using a P-value of <0.05. Results: The prevalence of anxiety was 36.4% while that of depression was 30.7%. The prevalence of suicidal ideation was 8.4%. The prevalence of suicidal ideation among adolescents who were <15 years was 8.0% while those who were between 15 - 18 years was 13.5% and those more than 19 years of age was 22.5%. The prevalence of suicidal ideation among adolescents with depression is 21.7% and 78.3 % for those without depression while the prevalence of suicidal ideation among adolescents with anxiety is 20.1% and 79.9 % for those without anxiety. The prevalence of suicidal ideation among the poorest half was 16.4% and 10.2% in the richer half. There was a higher prevalence of suicidal ideation among the urban dwellers (53.3%) than the rural dwellers (46.7%).There was a positive correlation between suicide and age in years and this was found to be statistically significant, (n=450, r=0.107, p=0.023). A significantly higher proportion of respondents who had depression, 21.7% had suicidal ideation when compared with those who were not, (χ 2=12.170, p<0.001). Similarly, a significantly higher proportion of respondents who had an anxiety disorder, (20.1%) had suicidal ideation when compared with those who were not, 9.4%, (χ 2=10.291, p=0.001). The respondents who were 19 years and above had increased suicidal ideation, and the difference in proportions was found to be statistically significant, (χ 2=6.440, p=0.040). A significantly higher proportion of females, 16.6% had suicidal intentions when compared with the males, 7.1%, (χ 2=7.958, p=0.005). Conclusion: There is an increasing prevalence of suicidal ideation among adolescents with a preponderance of older age and female gender. There is a link between depression/anxiety and suicidal ideation. The prevalence of suicidal ideation among the poorest half was higher than that of the richer half. There was a higher prevalence of suicidal ideation among the urban dwellers than the rural dwellers.

Willingness of college students aged 10 to 24 years to get vaccinated against COVID-19 disease: a cross-sectional study in South-East Nigeria.

Background: Willingness to be vaccinated against COVID-19 is a topical issue that may change the course and distribution of the pandemic in the country. Objectives: This study was aimed to determine the willingness to receive the COVID-19 vaccine among college adolescents and associated factors. Methodology: This was a cross-sectional study carried out among one thousand college adolescents in six secondary schools in Enugu from April to August 2021. A pretested, self-administered questionnaire was used for data collection. Data entry and analysis were done using IBM Statistical Package for Social Sciences (SPSS) statistical software version 25. Descriptive statistics were used to describe college adolescents' characteristics. Categorical variables were reported as frequencies and percentages. Predictors of willingness to vaccinate were assessed using binary logistic regression. Results: A minor proportion of the respondents, 13.2% (153) were willing to receive the COVID-19 vaccine. The respondents who were males were 1.6 times more willing to receive the COVID-19 vaccination when compared with those who were females. (AOR=1.6, 95%CI: 1.1- 2.3). The respondents who were aware they could be infected with COVID-19 were twice more likely to receive COVID-19 vaccination when compared with those who felt they could not be infected. (AOR=2.0, 95%CI: 1.1-3.1). The respondents who had good knowledge of COVID-19 vaccination were 2.2 times more likely to receive COVID-19 vaccination when compared with those who had poor knowledge. (AOR=2.2, 955CI: 1.5-3.3). Conclusion: A small fraction of college adolescents were willing to receive the COVID-19 vaccine. Male gender, knowledge of vaccine and possibility of transmitting infection are predictors of willingness to receive the vaccination.

Energy intake, expenditure and balance, and factors associated with energy balance of young adults (20-39 years): a retrospective cross-sectional community-based cohort study.

BACKGROUND: Obesity epidemic presents major challenge to chronic disease prevention. Young adults may be at higher risk due to consumption of energy dense foods/beverages and low physical activity. This study assessed the energy intake, expenditure and balance of 20-39 year-old adults and also evaluated factors associated with energy balance to provide basis for obesity prevention and control. METHODS: This retrospective cross-sectional cohort study involved 240 respondents selected through multistage random sampling. Data were collected through questionnaire, anthropometry and three 24-h dietary recall. Energy expenditure was assessed as the sum of resting energy expenditure (REE), energy expenditure of activity (EEA) and diet-induced energy expenditure of three days. Frequencies and percentages were employed in analysing general characteristics of the respondents. T-test and analysis of variance were used to assess relationships between and among numerical variables while relationships among categorical variables were evaluated through Chi-square test. Binary and multivariate logistic regression analyses were used to evaluate the factors associated with energy balance. RESULTS: Majority (53.2%) had normal body mass index and this decreased as age increased (P < 0.001); 23.8% had overweight, 21.7% had general obesity, 38.3% had abdominal obesity and 39.2% had high risk waist hip ratio. Total energy intake (TEI) of the respondents was 2416.0 ± 722.728 kcal/day. Males had lower energy intake (kcal/day) of 2398.8 ± 494.761 than females (2431.1 ± 876.664). Male intake contributed less (85.7%) than female intake (110.5%) to recommended energy intake. TEI (kcal/day) was lowest among 25-29 (2285.3 ± 497.793) but highest (2586.0 ± 467.587) among 35-39 year-olds (P < 0.05). Total energy expenditure (TEE) was 2195.5 ± 384.544 kcal/day; a value of 2274.3 ± 385.792 was found among males while the females had a lower value of 2126.6 ± 371.403. TEE (kcal/day) ranged from 2169.4 ± 411.625 in 20-24 to 2248.8 ± 273.534 in 30-34 year-olds. Those with general obesity had higher energy (kcal/day) intake (2733.7 ± 1171.073), expenditure (2431.7 ± 491.666) and balance (302.0 ± 1300.186) than those without obesity (P < 0.01). Energy intake (2573.0 ± 966.553) and expenditure (2226.4 ± 372.621) were significantly higher among those with abdominal obesity than those with normal waist circumference (P < 0.05). Overall positive energy balance of the adults was 220.5 ± 787.271. The females had higher positive energy balance (304.4 ± 921.041) than males (124.5 ± 588.637). Energy balance was lowest (102.5 ± 629.780) among 25-29 and highest (373.5 ± 494.546) in 35-39 year-olds. Most (68.8%) of the participants had positive energy balance. Age (AOR:2.89, 95% C.I.:1.27-6.56) and occupation (AOR:2.30, 95% C.I.:1.05-5.03) increased the likelihood of positive energy balance by 2. CONCLUSIONS: The study showed lower energy intake among the respondents than the recommended value; females had a value higher than what was recommended, males had less. Majority had positive energy balance and this was mostly found among those with obesity. Age and occupation were factors associated with positive energy balance. Nutrition education, health education and dietary counselling are recommended strategies to control sustained weight gain.

Determinants of primary healthcare services utilisation in an under-resourced rural community in Enugu State, Nigeria: a cross-sectional study.

Introduction: primary health care (PHC) is essential towards achieving universal health coverage. Improving PHC services require understanding context-specific factors influencing utilisation. We assessed the factors influencing utilisation of PHC services in a rural community in Enugu, Nigeria. Methods: we conducted a cross-sectional community-based survey between May and June, 2017. Information on socio-demographic characteristics, utilisation of PHC services, community- and PHC facility-related factors associated with utilisation of PHC services was obtained from 335 adult residents aged ≥ 18 years using a pre-tested semi-structured interviewer-administered questionnaire. Data were analysed using descriptive and inferential statistics at 5% level of significance. Results: of the 335 respondents, 155 (46.2%) reported utilisation of PHC services the last time they were sick. Of 178 respondents who did not utilise PHC services, 51 (28.7%) reported poor quality health services, 41 (23.0%) unavailability of medical doctors, 31 (17.4%) long patient waiting time and 25 (14.0%) unavailability of drugs as reasons for non-utilisation. Being a female (AOR = 2.3 (95% CI 1.3 - 4.0)), affordability of health services (AOR = 2.4 (95% CI 1.3 - 4.6)), inadequacy of healthcare staff (AOR = 0.3 (95% CI 0.1 - 0.5)), shorter hospital waiting time (AOR = 2.2 (95% CI 1.2 - 4.3)) and satisfaction with PHC services during previous visit (AOR = 2.6 (95% CI 1.1 - 6.3)) influenced utilisation of PHC services. Conclusion: PHC services utilisation was low. Improving utilisation would require addressing cost of health services, adequacy of healthcare staff, patient waiting time and ensuring patient satisfaction with PHC services.

Factors affecting adherence to anti-retroviral therapy among women attending HIV clinic of a tertiary health institution in SouthEastern, Nigeria.

Background: Strictly adherence to antiretroviral therapy (ART) is needed to achieve viral suppression. Studies have focused on HIV positive pregnant women's adherence. Factors affecting non-pregnant HIV positive women's adherence has been understudied in Enugu. Objective: The study objective was to identify factors affecting adherence to ART among HIV positive women attending retroviral clinic of a tertiary hospital in Enugu. Methods: Using a descriptive cross-sectional design, a pre-tested structured questionnaire was used for data collection among 286 HIV positive women aged 18 years and above. Data were analyzed using descriptive statistics of proportions, percentages, and means. Responses with a mean score of ≥2.5 were taken as important factor affecting adherence. Results: Overall adherence was 56.2%. Participants were considered adherent if they took ≥95% of their prescribed ART. Lack of transport fare (2.69 ±1.36), long-distance to clinic (2.82±1.26), health workers' poor attitude (2.74±1.28), and lack of partners' and parents' support (2.57±1.05) affected adherence negatively while ease in renewing prescription and minimal side effects of drugs enhanced adherence. Enfuvirtide (21.1%) and Lamivudine (17.4%) were drugs that were mostly skipped. Conclusions: Adherence to ART was low among the women attending the HIV clinic in Enugu. Adherence counseling and education should be provided before ART initiation. Strategies to reduce stigma, increase family support, and improve healthcare providers' attitudes should be employed.

Prevalence and patterns of gender-based violence in Enugu, Nigeria: a cross-sectional study.

Introduction: gender-based violence remains one of the most persistent human rights abuse in the world and with the emergence of the COVID-19 pandemic and its attendant mitigating protocols; Gender-based violence (GBV) could be on the rise with changes in its pattern and presentation. The aim of the study was to determine the prevalence and patterns of GBV among victims presenting in a tertiary health facility in South-East Nigeria during the first phase of the COVID-19 pandemic. Methods: this was a retrospective cross-sectional study, among 710 victims of GBV, who reported and received care at the GBV unit in a tertiary hospital in Enugu, South-east Nigeria. A pro forma designed by the researchers was used to collect secondary data from GBV facility screening forms and folders of all patients that reported any form of GBV over a 3-year period (2018 - 2020). Results: majority (89.9%) of victims of GBV were females and over a half (51.4%) of the cases were in the age group 20-39 years. In total, 56.8% of the GBV cases had been sexually abused. The pattern of GBV over the three years period under study revealed an increase in proportion for both sexual and physical/emotional violence, with a peak in 2019 and a reduction of cases in 2020. Persons below 19 years of age were 23 times more likely to experience sexual violence, than those between 40-59 years of age (AOR: 23.332; 95% CI: 11.037 -49.325) p<0.001. Males were 11 times more likely to experience physical/emotional violence than females (AOR: 11.136; 95% CI: 4.685-26.471) p<0.001. Age, gender, urban dwelling and year of occurrence were significant predictors of GBV. Conclusion: GBV is a cause for concern in Enugu Nigeria; affecting mainly young female victims in their prime. There is an increase in reported cases of GBV in Enugu Nigeria with sexual abuse being more prevalent.

Infection prevention and control: knowledge, determinants and compliance among primary healthcare workers in enugu metropolis, south-east nigeria.

Introduction: Healthcare workers have lost their lives in significant numbers in the discharge of their duties as a result of a breach in Infection Prevention and Control (IPC) procedures. The increasing incidence of emerging and re-emerging diseases complicates this burden. Adequate IPC includes administrative, environmental and personal protective control measures. This study assessed the knowledge, determinants and compliance to IPC among primary healthcare workers in Enugu Metropolis. Methodology: A cross-sectional study was done using a semi-structured interviewer-administered questionnaire. A multi-stage sampling technique was used to select 300 eligible Health Care Workers in Primary Health Care facilities. Analyses were done using IBM-SPSS version 23. Ethical approval was obtained from the Health Research Ethics Committee of UNTH Enugu. Results: The majority of the respondents were Community Health Extension Workers (CHEWs) or Community Health Officers (CHOs) and nurses 122 (40.7%), 197(65.7%) were female; with a mean age of 39.86 ± 9.62 years. Only 254(84.7%) of the respondents had previous IPC training and 82(27.3%) of them had good knowledge of IPC. Needle-stick injury was identified as a source of occupational exposure to infections amongst 185(61.7%). A majority, 244(81.3%) could not correctly identify all the moments of hand washing. Conclusion: The demonstrated poor level of knowledge and compliance to IPC demands more research to unravel this existing gap. However, these conditions can be improved by training the workers on IPC.

Pentazocine with rectal diclofenac versus pentazocine alone for pain relief following caesarean delivery in Enugu, Nigeria: A randomized controlled trial.

OBJECTIVE: To measure postoperative pain relief following the use of rectal diclofenac combined with intramuscular pentazocine compared with intramuscular pentazocine alone in patients undergoing a caesarean delivery. METHODS: This single-blind randomized controlled trial enrolled pregnant women that had a caesarean section at the Enugu State University of Science and Technology Teaching Hospital, Enugu, Nigeria. Study participants were randomized to receive either 100 mg of rectal diclofenac given every 12 h plus 30 mg of intramuscular pentazocine given every 6 h (group A) or 60 mg of intramuscular pentazocine given every 6 h (group B). The primary outcome was the level of pain as measured using a visual analogue scale. The secondary outcomes were the level of satisfaction with pain relief and need for rescue analgesia. RESULTS: A total of 200 participants were randomized equally into the two groups. Participants in group A had significantly better pain control and satisfaction over the 48 h after surgery compared with group B. Significantly more of group B required rescue analgesia for breakthrough pain compared with group A. CONCLUSION: Rectal diclofenac combined with intramuscular pentazocine was significantly better at controlling pain compared with pentazocine alone in the first 48 h following caesarean section.Trial registration number: PACTR202107706925314 at www.pactr.org on 28 July 2021.