Improving knowledge about breast cancer and breast self examination in female Nigerian adolescents using peer education: a pre-post interventional study.

BACKGROUND: Prevention of BC of which the cornerstone is creating awareness and early detection is important in adolescents and young women because of their worse outcomes. Early detection strategies such as mammography are currently beyond the reach of most women in sub-Saharan Africa.. Lack of awareness and late presentation contribute to the poor outcomes. Awareness creation among adolescents may result in modification of some risk factors for BC with adoption of healthy life styles including accessing early detection activities. This study determined the effect of peer education as a strategy to create awareness on BC and breast self examination (BSE) among in-school female adolescents in Benin City. METHODS: This was a pre-post interventional study carried out in October -December 2016 on female students of four secondary schools in Benin City. Pre-peer training, using a pre-tested self-administered questionnaire, knowledge about BC and BSE was assessed in about 30% of each school population. This was followed by training of 124 students selected from the schools (one student per class) as peer trainers. The peer trainers provided training on BC and BSE (the intervention) for their classmates. Within two weeks of peer training knowledge about BC and BSE was reassessed in 30% of each school population. Selection of students for assessment pre and post intervention was by systematic sampling. Correct knowledge was scored and presented as percentages. Chi square test, student t test and ANOVA were used to assess associations and test differences with level of significance set at p < 0.05. RESULTS: There were 1337 and 1201 students who responded to the pre and post-training questionnaires respectively. The mean BC knowledge score (20.61 ± 13.4) prior to training was low and it statistically significantly improved to 55.93 ± 10.86 following training p < 0.0001 Following peer training, statistically significant improvement (p 0.037- < 0.001) occurred in most knowledge domains apart from symptomatology. Pre-peer training 906(67.8%) students knew about BSE but only 67(4.8%). Significantly more students 1134(94.7%) knew about BSE following peer training. CONCLUSIONS: Peer education strategy can be used to improve BC and BSE knowledge in adolescents. This strategy is low cost and could be very useful in low resource settings.

Peak expiratory flow rate variability in apparently healthy school children aged 10-15 years in Oredo, Nigeria.

OBJECTIVE: To study the peak expiratory flow rate variability (PEFRVar) in apparently healthy school children in Oredo, Nigeria. METHODS: We carried out a cross-sectional study of 438 subjects (10-15 years), attending the public junior secondary schools, between March and November 2005. The study took place in the Oredo Local Government Area. The age and anthropometry were taken and PEFRVar was determined using values obtained at 6 AM, 2 PM, and 10 PM over a 14-day period, using a mini-Wright peak expiratory flow meter. RESULTS: Peak expiratory flow rate variability (mean+/-SD) was 4.5+/-1.3% for all subjects (4.4+/-1.0% for males, and 4.6+/-1.6% for females). Females had higher PEFRVar. The upper limits of 95% CI were 7.1% for all subjects (6.4% for males, and 7.8% for females). The PEFRVar showed an inverse relationship with height, age, and weight. Regression equations for PEFR and PEFRVar were derived for age, height, and weight. CONCLUSION: Based on upper limit of 95% CI for all subjects, a PEFRVar cut-off of 7.1% is recommended for diagnosis of significant airway obstruction as in asthma in the age bracket under review in Oredo and perhaps other areas, sharing similar geo-physical and social characteristics.

Effect of Peer Education on Knowledge of Human Papilloma Virus and Cervical Cancer among Female Adolescent Students in Benin City, Nigeria.

INTRODUCTION: It is well documented that Human Papilloma Virus (HPV) is the cause of cervical cancer which is a major cause of morbidity and mortality especially in low- and middle-income countries. Vaccines against HPV are available. In developed countries where the vaccines have been deployed, lack of information among the target population (adolescents) is a major contributor to suboptimal uptake. In Nigeria, the vaccine is yet to be provided in the national programme on immunization, which is free, but it is available for a fee. In this study we determined the effect of peer education on the knowledge of female adolescents about HPV, cervical cancer, its treatment and prevention. METHODS: This was an intervention study. The knowledge and awareness of female students of four secondary schools were assessed using a pre-tested self-administered questionnaire prior to the training of some of the students (peers). The trained students delivered messages on cervical cancer and HPV using fliers containing key information (peer training) to their school mates in formal delivery in a class setting. The knowledge and awareness of students, post-peer training, was then assessed. RESULTS: There were 1337 students who responded to the baseline questionnaire while 1201 responded to the post-peer training questionnaire. Awareness of cervical cancer, knowledge of risk factors and cause of cervical cancer was low prior to the peer training. There was statistically significant improvement in awareness about cervical cancer and in the knowledge domains following peer training. Mean knowledge score prior to training was 12.94 ± 9.23 and this increased significantly to 53.74 ± 10.69 following peer training p < 0.0001. CONCLUSION: Peer training is effective in improving knowledge and awareness of secondary school students about HPV and cervical cancer.

Anti-diphtheria immunity in Nigerian mothers and their newborns.

BACKGROUND: Immunity to diphtheria has been noted to wane with age such that previous studies have shown that a significant proportion of females with characteristics comparable to those of Nigerian women of reproductive age have inadequate levels of immunity to diphtheria. Thus, it is envisaged that Nigerian newborns may inherit inadequate levels of immunity to diphtheria from their mothers. METHODS: Cord blood and peripheral maternal blood samples were collected from 231 mother-infant pairs at delivery. Anti-diphtheria antibody titres were assayed using Enzyme-linked immunosorbent assay (ELISA) technique. Recruited babies were those born at term with normal birth weight. RESULTS: As much as 29.9% of both mothers and their babies had no protection (antibody titre<0.01 IU/ml) from diphtheria. Ninety (39.0% CI 33%,45%) mothers and 107 (46.3% CI 40%,52%) babies were inadequately protected (antibody titre<0.1 IU/ml) from diphtheria. The difference in the geometric mean antibody titres of mothers and babies was statistically significant (p<0.0001). There was a strong positive linear correlation between maternal and newborn antibody titres ("r"=0.983, p<0.0001), such that, as mothers antibody titres increased those of their babies also increased. CONCLUSION: Significant proportions of Nigerian mothers and newborns are at risk of developing diphtheria. Vaccination of parturient women with booster doses of diphtheria toxoid vaccine is recommended.

Mucocutaneous manifestation of pediatric human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) in relation to degree of immunosuppression: a study of a West African population.

BACKGROUND: Mucocutaneous lesions occur at one point or the other during the course of human immunodeficiency virus (HIV) disease. These lesions can be the initial presenting features but could also be a pointer to the presence of immunosuppression. AIM AND OBJECTIVES: This study was carried out to determine the pattern of mucocutaneous manifestation in children who have human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) in relation to their level of immunosuppression. METHODS: One hundred children who were HIV seropositive aged 18months to 16years were evaluated for mucocutaneous lesions, and their degree of immunosuppression was also determined using total CD(4+) count or CD(4+) percentage. Another group of age and gender matched 100 HIV-negative children were also examined for mucocutaneous lesions. RESULTS: The mucocutaneous manifestations were more common among the subjects compared to controls (P=0.000). The overall prevalence among the seropositive and seronegative subjects was 64% and 12% respectively. The prevalence of mucocutaneous findings in children with severe, moderate, and no immunosuppression were 93.8%, 55.2%, and 46.2%, respectively. The lesions were significantly more common among those with moderate and severe immunosuppression compared to those with no immunosuppression (P=0.000). Multiple lesions were more frequent among those with severe immunosuppression. Oral thrush was the most frequent lesion (25.6%) among the subjects followed by pruritic papular eruption (20.7%) and dermatophytosis (14.1%). Severe and atypical forms of dermatophytosis and herpes ulcer were also observed among the subjects. CONCLUSION: This study shows that mucocutaneous lesions are common in children with HIV/AIDS and could be an early indicator of immune suppression. It is important to recognize them early in order to enhance early case detection and treatment.