Prevalence and predictors of child labour among junior public secondary school students in Enugu, Nigeria: a cross-sectional study.

BACKGROUND: Globally, millions of children are involved in child labour. However, low- and middle-income countries are mostly hit. This study examined the predictors of child labour among public secondary school students in the Enugu metropolis. METHODS: This was a descriptive cross-sectional study of 332 junior secondary students attending public schools in Enugu metropolis, Nigeria. Multistage sampling technique was used to select the six secondary schools and the students that participated in the study. Data collection was done from September to October 2018. Pretested structured, interviewer-administered questionnaire was used for data collection. The questionnaire contained information on the sociodemographic variables, the kind of work done by the respondents and the number of working hours spent weekly. UNICEF's standard indicator for child labour was used to estimate the prevalence of child labour. Logistic regression was used to identify socioeconomic predictors of child labour. RESULTS: The prevalence of overall child labour was 71.7%, while for domestic and economic child labour prevalence were 52.1 and 34.0%, respectively. About 35.2% of the respondents worked under hazardous conditions while 8% were forced to work. Two-thirds (236, 65%) of the respondents who have heard about child labour perceived it as wrong. The child labourers mainly worked to render financial assistance to their parents. The predictors of child labour were class of study (AOR = 2.208 (95% CI: 1.199-4.066) and weekly income earned (AOR = 0.316 (95% CI: 0.176-0.567). CONCLUSION: The prevalence of child labour among junior students in public secondary schools in Enugu is high, and is predicted by the level of schooling and income earned. Economic and social reforms could contribute to addressing the predictors of child labour.

Variations in utilization of health facilities for information and services on sexual and reproductive health among adolescents in South-East, Nigeria.

BACKGROUND: Adolescents' sexual and reproductive health has an important influence on a country's long-term national growth. There is a high level of burden due to poor adolescent sexual and reproductive health (ASRH) in Nigeria, especially the Ebonyi State. Evidence shows that in the Sub-Saharan African region, most adolescents experience poor access to information and other services relating to their sexual and reproductive health. Many cultures in Africa see matters around sex and sexuality as social taboos. AIMS: This study aimed to access variations in the utilization of health facilities for sexual and reproductive health information and services among adolescents in the Ebonyi State, Nigeria. This will inform the design of interventions to improve ASRH. PATIENTS AND METHODS: A total of 1,057 in-school and out-of-school adolescents aged 13-18 years were selected using cluster sampling of households from the six selected local government areas (LGAs) in this cross-sectional survey. Structured questionnaires were used to collect data. Descriptive statistics were performed alongside stratification analysis. Tabulation, bivariate and multivariate logistic regression analyses were undertaken. A household wealth index was calculated using the total household consumption calculated divided by the number of people in the household (per capita household consumption). The per capita household consumption was used to categorize the households into socioeconomic quintiles. The variable was used to differentiate key variables into socioeconomic quintile equity analysis. RESULTS: A majority of the respondents had never visited any type of health facility to receive either sexual and reproductive health (SRH) information (90.2%) or services (97.1%). The utilization rate of health facilities for SRH information was 9.8% while for other SRH services was 2.8%. The patent medicine vendor (PMV) was the most visited type of facility for SRH information and other services. Schooling was a strong predictor of health facilities' utilization for SRH information (P < 0.01) and other services (P < 0.01). CONCLUSION: Utilization of health facilities for information and services among adolescents in the Ebonyi State is very low and favorable toward informal service providers such as PMVs. The establishment and strengthening of the existing youth-friendly centers, school clinics, and occasional outreach programs designed specifically to target adolescents would perhaps improve adolescents' access to adequate information and health facility utilization for sexual, reproductive, and health services.

Subdural empyema: Clinical presentations and management options for an uncommon neurosurgical emergency in a developing country.

BACKGROUND: Controversy regarding the best management strategy for subdural empyema (SDE) attests to the persisting poor outcomes for this uncommon life threatening intracranial suppurative process. Late presentation confounds the problem in developed countries. While craniotomy is commonly recommended, it is not always possible in late presentation with advanced morbidity. The aim of this study was to identify the pattern of clinical presentation and explore the outcomes following management of SDE using burr hole, aspiration, and drainage (BAAD) in resource poor settings. MATERIALS AND METHODS: This is a retrospective review of prospectively collected data of 18 patients presenting with SDE over a period of 10 years from two neurosurgical centers. Data was abstracted on patients' demographic characteristics, sources of SDE, clinical presentation and site of infection, methods of diagnosis, organisms isolated, treatments received, and outcome. Collected data was entered into the Statistical Package for the Social Sciences version 17 software and subjected to descriptive analysis for all variables. RESULTS: Majority of the patients presented late with Glasgow Coma Scale score GCS of 9/15. Altered sensorium was noted in 14 (77.8%) of the patients, 11 (61.1%) out of the 14 patients had ≤ grade 3 of Bannister and Williams level of consciousness. The mainstay of treatment for all patients was BAAD of abscess and administration of appropriate antibiotics. Fourteen patients (77.8%) were discharged on grade A of H.W. Mauser's grading system. Three mortalities were recorded only in patients who had grade 4 Bannister and Williams grading. CONCLUSION: BAAD is the near approximated option to standard craniotomy management in a limited resource facility and it has a very good clinical outcome. However, more studies are required to draw the final conclusion.

Inequity in access to childhood immunization in Enugu urban, Southeast Nigeria.

BACKGROUND: The Nigerian National Programme on Immunization aims at increasing the immunization coverage of children under 1 year of age. However, there is still a gap between the national immunization targets and the immunization coverage rates, and data are rarely disaggregated according to socioeconomic status. As a result, there is a dearth of information about the coverage of subgroups, especially at the local level. This study determined the socioeconomic differentials in immunization coverage for children under 5 years and under 1 year in Enugu urban, Southeast Nigeria. METHODS: This was a community-based, descriptive cross-sectional study in Enugu urban of Southeast Nigeria. A modified 30 × 7 cluster sampling design was adopted as the sampling method to select and interview 462 mothers of 685 children under the age of 5 years on their sociodemographic and economic characteristics and immunization status of their children. Principal components analysis in STATA software was used to characterize socioeconomic inequity. RESULTS: Immunization coverage was as follows: Diphtheria, pertussis, tetanus third dose(DPT3), 3, 65.3%; oral polio vaccine 3, 78.0%; hepatitis B3, 65.2%; and measles, 55.8%. The full immunization rates for children 1-5 years and st year of life was selected as the reference group, the immunization rates in all other age groups decreased significantly. Using the same logistic regression model for children under 1 year of age, every added month of the child's life increased the full immunization coverage, and this was statistically significant (OR 2.752, 95% CI 2.304-3.418). CONCLUSIONS: Full immunization coverage for children aged < 1 year was lower than the national target of 95%. There are differences in immunization coverage rates between different wealth quartiles in the area with the least poor benefiting more than the poorest, thus creating equity problems. Health managers need such community-based information about the vaccination status of their target population to plan and implement interventions that aim to improve immunization coverage in these areas.