Neonatal jaundice incidence, risk factors and outcomes in 54 referral-level facilities in Nigeria.

OBJECTIVE: To determine the incidence, risk factors and outcomes of babies with neonatal jaundice in a network of referral-level hospitals in Nigeria. DESIGN: A cross-sectional analysis of perinatal data collected over a 1-year period. SETTING: Fifty-four referral-level hospitals (48 public and 6 private) across the six geopolitical zones of Nigeria. POPULATION: A total of 77 026 babies born at or admitted to the participating facilities (67 697 hospital live births; plus 9329 out-born babies), with information on jaundice between 1 September 2019 and 31 August 2020. METHODS: Data were extracted and analysed to calculate incidence and sociodemographic and clinical risk factors for neonatal jaundice. MAIN OUTCOME MEASURES: Incidence and risk factors of neonatal jaundice in the 54-referral hospitals in Nigeria. RESULTS: Of 77 026 babies born in or admitted to the participating facilities, 3228 had jaundice (41.92 per 1000 live births). Of the 67 697 hospital live births, 845 babies had jaundice (12.48 per 1000 live births). The risk factors associated with neonatal jaundice were no formal education (adjusted odds ratio [aOR] 1.68, 95% CI 1.11-2.52) or post-secondary education (aOR 1.17, 95% CI 0.99-1.38), previous caesarean section (aOR 1.68, 95% CI 1.40-2.03), booked antenatal care at <13 weeks or 13-26 weeks of gestation (aOR 1.58, 95% CI 1.20-2.08; aOR 1.15, 95% CI 0.93-1.42, respectively), preterm birth (aOR 1.43, 95% CI 1.14-1.78) and labour more than 18 hours (aOR 2.14, 95% CI 1.74-2.63). CONCLUSIONS: Hospital-level and regional-level strategies are needed to address newborn jaundice, which include a focus on management and discharge counselling on signs of jaundice.

Maternal morbidity and death associated with pregnancy loss before 28 weeks in Nigeria.

OBJECTIVE: To determine the prevalence of maternal morbidity and death from pregnancy loss before 28 weeks in referral-level hospitals in Nigeria. DESIGN: Secondary analysis of a nationwide cross-sectional study. SETTING: Fifty-four referral-level hospitals. POPULATION: Women admitted for complications arising from pregnancy loss before 28 weeks between 1 September 2019 to 31 August 2020. METHODS: Frequency and type of pregnancy loss were calculated using the extracted data. Multilevel logistic regression was used to determine sociodemographic and clinical factors associated with early pregnancy loss. Factors contributing to death were also analysed. MAIN OUTCOME MEASURES: Prevalence and outcome of pregnancy loss at <28 weeks; sociodemographic and clinical predictors of morbidity after early pregnancy loss; contributory factors to death. RESULTS: Of the 4798 women who had pregnancy loss at <28 weeks of pregnancy, spontaneous abortion accounted for 49.2%, followed by missed abortion (26.9%) and ectopic pregnancy (15%). Seven hundred women (14.6%) had a complication following pregnancy loss and 99 women died (2.1%). Most complications (26%) and deaths (7%) occurred after induced abortion. Haemorrhage was the most frequent complication in all types of pregnancy loss with 11.5% in molar pregnancy and 6.9% following induced abortion. Predictors of complication or death were low maternal education, husband who was not gainfully employed, grand-multipara, pre-existing chronic medical condition and referral from another facility or informal setting. CONCLUSION: Pregnancy loss before 28 weeks is a significant contributor to high maternal morbidity and mortality in Nigeria. Socio-economic factors and delays in referral to higher levels of care contribute significantly to poor outcomes for women.

Overweight and obesity status of school adolescents in Portharcourt, southern Nigeria.

Background: Adolescent overweight and obesity has been linked to obesity in adult life, with its associated risks of chronic diseases including cardiovascular diseases. Thus, prevention aimed at early screening and surveillance should be the key. The aim of this study is to determine the prevalence of overweight and obesity among schooling adolescents in Port Harcourt. Mateials and Methods: A cross sectional study was carried out on 2,282 secondary school students aged 10­19 years, using a structured questionnaire to obtain data. Weights and height were measured using standard methods. The Body Mass Index (BMI) was calculated from their weights and heights in kg/m.2 The nutritional status of the students was determined using the BMI percentile charts for age and gender as recommended by the World Health Organisation in 2007. Results: The prevalence of overweight and obesity were 13.2% and 4.6%.The female subjects had a higher prevalence of overweight and obesity (14.6% and 5.2%) than the males (11.4% and 3.8%) and this difference was statistically significant (P = 0.041). Conclusion: The prevalence of overweight and obese adolescents in Port Harcourt is high. We recommend that health education with emphasis on lifestyle changes and behavioral modification that will promote healthy eating and regular physical activities be inculcated into the curriculum of secondary schools in Nigeria.

Prevalence and determinants of cigarette smoking among adolescents in secondary schools in Port Harcourt, Southern Nigeria.

BACKGROUND: Cigarette smoking remains a major preventable public health problem associated with premature deaths worldwide. Adolescence is a unique developmental stage between childhood and adulthood. Smoking is a lifestyle habit acquired during adolescence and into adulthood, with its associated morbidity and mortality. It is therefore important to determine the factors associated with cigarette smoking in these adolescents in order to institute preventive measures and health policies to protect these adolescents early. OBJECTIVE: This study aims to determine the prevalence of smoking, factors associated with smoking, and knowledge of the harmful effects of smoking in these adolescents. METHODS: A cross-sectional study of 1120 adolescents aged 10-19 years selected from 10 secondary schools in Port Harcourt was conducted using a multistage sampling technique. The Global Youth Tobacco Survey (GYTS) core questionnaire was used to collect data from the subjects. A smoker was defined as one who had ever smoked a cigarette or who had one or two puffs, while a current smoker was defined as one who had taken a puff or smoked cigarettes in the last 30 days preceding the day of the questionnaire's completion. RESULTS: Eighty subjects (7.1%) were smokers. This was significantly (p=<0.001) higher in males (9.7%) than in females (4%). Thirty seven (3.3%) subjects were current smokers. The mean age at which smoking was initiated was 12.47±3.0 years. Twenty six (32.5%) of the smokers reported that they were initiated into cigarette smoking by their friends, 36 (45%) just wanted to experiment, 7 (8.8%) were influenced by media advertisements while 5 (6.3%) were due to parental exposure. Parental history of smoking and poor knowledge of cancer of the lungs as a harmful effect of smoking, was significantly (p=<0.05) associated with cigarette smoking. CONCLUSION: The prevalence of smoking in adolescents in Port Harcourt is high and is associated with parental smoking and poor knowledge of cancer of the lungs as a harmful effect. We recommend that adolescent health education with an emphasis on the harmful effects of smoking be included in the curriculum of all secondary schools.

Prevalence of bullying in secondary schools in Port Harcourt.

BACKGROUND: School bullying is a global problem involving a high proportion of students worldwide. However, its prevalence and types in secondary schools in Port Harcourt is not yet known. OBJECTIVE: This study aimed to determine the prevalence and types of bullying in secondary schools in Port Harcourt. SUBJECTS: A total of 1160 students from six secondary schools in Port Harcourt comprised the sample. MATERIALS AND METHODS: This was a cross-sectional school-based study conducted in Port Harcourt in March 2014. Two mixed schools, two all-boys schools, and two all-girls schools were selected using purposive sampling technique. Stratified random sampling technique, by class strata (senior secondary 1, 2 and 3) was used to select 1160 students from the six schools. A 22-item self-administered questionnaire adapted from a previous study was modified and used in this study. The questions covered the prevalence, type of bullying, and socio-demographic data. Data were analyzed using SPSS version 20 (IBM SPSS Incorporated, Chicago, IL, USA). RESULTS: About 82.2% reported being victims of bullying, whereas 64.9% reported being bullies. About 9.7% and 11.8% were neither bullies nor bullied, respectively. Bullying was significantly higher in the all-boys (90.8%) and all-girls (82.9%) schools than in the mixed schools (73.5%), p=0.000. More males were victims (53.4%) and bullies (53.3%) but more females (55.4%) were bully-victims. The most common (57.5%) type of bullying was physical bullying. CONCLUSION: The rate of bullying was found to be very high in secondary schools in Port Harcourt.