Knowledge of Breast Cancer and Practice of Breast Cancer Screening among Female Teachers in an Urban Local Government Area in Lagos State, Southwestern Nigeria.

BACKGROUND: Breast cancer is a global health concern and a leading cause of death among women in the world. Enhancing breast cancer screening in developing countries is pivotal in improving women's health. Aim of this study was to assess the knowledge of breast cancer and practices of breast cancer screening. METHODS: Study design was a descriptive cross sectional study among 348 public senior secondary school female teachers in Surulere LGA. Data was collected using a pretested, structured, open-ended and close-ended self-administered questionnaire. Questions on knowledge of breast cancer and practice of breast cancer screening were scored and graded as good (>50%) and poor (< 50%). The Univariate and bivariate analyses were carried out. Pvalue <0.05 was considered statistically significant. RESULTS: A total of 332 out of the 348 administered questionnaires were retrieved and analyzed giving a response rate of 95.40%. Respondents' ages ranged from 24-58 years with a mean of 42.61±5.53 years. Overall knowledge of breast cancer was good among 308(92.77%) of the respondents. Majority 264(79.52%) of the respondents performed breast self-examination (BSE), 240(72.29%) have had clinical breast examination (CBE) performed for them by a health personnel and 216(65.06%) of the respondents reported they have had a mammogram. CONCLUSION: Majority of the respondents had good knowledge of breast cancer. Most common practice of breast cancer screening was BSE, followed by CBE and lastly mammogram. Health education/awareness campaigns are therefore recommended to improve and sustain the existing knowledge and breast cancer screening practices.

Knowledge, attitude and practice of hepatitis B vaccination among health workers at the Lagos State accident and emergency centre, Toll-Gate, Alausa, Lagos State.

BACKGROUND: Hepatitis B virus infection is a priority job related disease that has both serious public and private health implications. Hepatitis B vaccine is the first anticancer vaccine that has outstanding record of safety and effectiveness and 95% effective in preventing children and adults from developing chronic infection. STUDY DESIGN/METHODOLOGY: The study design was a cross-sectional descriptive study. All the 88 health workers at the Lagos state accident and emergency centre who gave their consent to participate in the study were enrolled. Pre-tested, structured, self-administered questionnaire was used for data collection. RESULTS: Majority (70.2%) had good knowledge of hepatitis B infection and vaccination and the mean knowledge score (%) was 61.2 ± 20.7. Majority (90.4%) knew that hepatitis B virus can be acquired through a needle stick injury. Majority (67.9%) were aware of the existence of an effective vaccine against hepatitis B infection; however, only 45.1% knew correctly that a post hepatitis B vaccination test is necessary to confirm protection. Majority (86.9%) knew that a complete dose of hepatitis B vaccine is 95% effective; however, only 49.4% knew for how long the vaccine protects. Only 36.9% knew correctly that hepatitis B virus is 100 times more infectious than HIV. Attitude towards hepatitis B vaccination was good among all of the respondents and the mean attitude score (%) was 92.9 ± 14.3. Majority (84.5%) had poor practice of hepatitis B vaccination and the mean practice score (%) was 24.2 ± 25.0. Among those who did not receive the vaccine, majority (67.6%) gave non-availability of the vaccine as reason for this. CONCLUSION: The respondents had good knowledge and good attitude but poor practice of hepatitis B vaccination. There is therefore need to provide health workers with adequate information on blood-borne viruses in order to reinforce the knowledge and attitude which will eventually translate into a good practice of hepatitis B vaccination. A clear and concise immunization policies and effective monitoring should be put in place to ensure compliance at all government health facilities.

The effect of nail polish and acrylic nails on pulse oximetry reading using the Lifebox oximeter in Nigeria.

AIMS AND OBJECTIVES - Pulse oximetry is mandatory during anaesthesia, sedation and transfer of critically ill patients. The effect of nail polish and acrylic nails on the accuracy of saturation reading is inconsistent. The Lifebox pulse oximeter is reliable and recommended for low and middle income countries. We investigated its accuracy in the presence of 4 nail colours and acrylic nails SUBJECTS AND METHODS Fifty non-smoking volunteers had their fingers numbered from right to left (little finger of right hand =1 and little finger of left hand =10). Alternate fingers were nails painted with clear, red, brown and black nail polish and the 5th finger had acrylic nail applied. The corresponding finger on the other hand acted as control. The oxygen saturation was determined using the Lifebox pulse oximeter. Results All fingers (100%) with clear nail polish, red nail polish and acrylic nails recorded a saturation value. Each of the mean saturation value for clear nail polish, red nail polish and acrylic nails was not significantly different from the control mean (p= 0.378, 0.427 and 0.921). Only 12% and 64% of nails polished black and brown respectively recorded a saturation value. The mean SpO- for black and brown polish were significantly different from their control mean (p<0.001). CONCLUSION Black and brown polish resulted in a significant decrease in SpO with the Lifebox oximeter. Dark coloured nail polish should be removed prior to SpO2 determination to ensure that accurate readings can be obtained.

Knowledge, prevalence and psychological effect of miscarriage among women of reproductive age group attending obstetrics and gynaecology clinics of Lagos University Teaching Hospital, Nigeria.

AIMS AND OBJECTIVES: To determine the knowledge, prevalence and psychological effect of miscarriage among women of reproductive age attending the obstetrics and gynaecology clinics of a tertiary healthcare facility in Lagos Nigeria. MATERIALS AND METHODS: Study design was a descriptive cross sectional study and 300 respondents were enrolled. A pre-tested interviewer-administered questionnaire and Multiple Affect Adjective Check List (MAACL) authored by M. Zukerman and B. Lubin (1965) were used for data collection. Responses of the respondents on the knowledge of various aspects of miscarriage was scored and graded as good (e"50%) and poor (^ <50%). The study was carried out in February 2011. RESULTS: Response rate was 97%. Only 0.7% of the respondents were not aware of miscarriage. A total of 214(73.5%) of the respondents had good knowledge of miscarriage and the mean knowledge score (%) was 60.4 ± 22.1. Most common myth about the cause of miscarriage among the respondents was eating of snail (63.2%). About 49% of respondents who had ever been pregnant have had miscarriage. Approximately 1 in 3.7 pregnancies was miscarried. The level of emotional distress in terms of anxiety, depression and hostility is significantly higher in women who have had miscarriage than their counterparts who had not. CONCLUSION: Level of knowledge of miscarriage was high though some miscarriage myths exist among the respondents. Approximately 1 in 3.7 pregnancies was miscarried. Miscarriage had negative psychological effect on women.

The effect of health education on the knowledge, attitude, and uptake of free Pap smear among female teachers in Birnin-Kebbi, North-Western Nigeria.

INTRODUCTION: The Routine Pap smear test has successfully reduced the incidence of invasive cervical cancer in the presence of a proper structure for its implementation. This study was designed to assess the effect of health education on the knowledge, attitude, and uptake of Pap smear among female teachers. MATERIALS AND METHODS: It was a quasi-experimental, controlled study with a pre-test, post-test design. A total of 100 respondents were recruited for each of the intervention and control groups, by the multistage sampling technique. RESULTS: The mean knowledge score of cervical cancer was low in both the interventions (25.5% ± 10.5) and control groups (18.9% ± 10.0) at baseline; a significant rise to 57.2% ± 20.7 was recorded after the intervention in the Intervention group (P<0.0001). The baseline mean attitude score was also low in the intervention and control groups (17.1% ± 6.3 and 14.1% ± 6.4, respectively); post intervention there was a significant rise of up to 28.0% ± 12.8 in the Intervention group (P<0.0001). The proportion of respondents with a reported practice of Pap smear was low and similar in both the groups at baseline (1.1 and 4.9% in the intervention and control groups, respectively, P=0.16). Uptake of free Pap smear was poor at the post-intervention phase in both the groups (P=0.45). Reported reasons for poor uptake included the respondents' dislike for the test (38.4%) and the belief that the test was not necessary (24.4%). About 20% of the respondents did not have any reason at all. CONCLUSION: Health education had no significant effect on the uptake of a free Pap smear among teachers. Despite the significant improvement in the attitude toward the test, many respondents did not like the test after than before the intervention. Sociocultural issues such as the gender of the sample collector, and system factors like few service delivery points, and the time required to access the service could have contributed to the poor uptake recorded in this study. A program designed to improve routine cervical cancer screening by Pap smear should therefore address not only the knowledge and cost, but also the sociocultural and systemic factors.

Domestic refuse management practice in Sokoto: the effect of health education.

AIMS AND OBJECTIVES: Domestic refuse remains a major environmental concern in large cities around the world. Its management also continues to be a major challenge. The aim of this study was to assess the effect of health education on the knowledge, attitude and practices of domestic refuse management (DRM) among community members in Sokoto metropolis. MATERIALS AND METHODS: A quasi experimental study design was employed to investigate two sampled (intervention and control groups) population of 225 subjects in the study areas. RESULTS: The mean knowledge score (%) of the study subjects was high and similar (p=0.82), in both the intervention and control groups at baseline, but differed significantly (p<0.0001) at post-intervention. The mean attitude score (%) was high and similar (p=0.38), in both the intervention and control groups at baseline, but differed significantly (p=0.008) at post intervention. The mean observed practice score (%) was low and similar (p=0.42), in both the intervention and control groups at baseline, but differed significantly (p<0.0001) at post-intervention. CONCLUSION: This study has identified the underlying problem of our DRM system to be inherent in the practice component in the triangulation of knowledge, attitude and practice of DRM. The implications of the study findings for healthcare policy, planning and implementation cannot be over-emphasised.

A COMPARISON OF THE OBJECTIVE STRUCTURED CLINICAL EXAMINATION AND THE TRADITIONAL ORAL CLINICAL EXAMINATION IN A NIGERIAN UNIVERSITY.

BACKGROUND: Assessment of clinical skills is essential in medical education. Ideally marks should be based on the student's competence alone. The limitations of the traditional long case examinations such as the patient and examiner variability are well known. The objective structured clinical examination (OSCE) was designed to overcome these limitations. Studies comparing the OSCE and the traditional long case examination in the same group of students are very sparse. AIM: To compare the objective structured clinical examination (OSCE) and the traditional long case examination by determining their correlations with other forms of assessment in undergraduate surgery. SETTING: This study was carried out at the College of Medicine, University of Lagos, Nigeria. METHODOLOGY: The results of 612 undergraduate students in our medical school of the University of Lagos, Nigeria over a period of 4 years (2012-2015) were analysed. The scores in the long case examination , objective structured clinical examination (OSCE) , multiple choice questions and Essays were analysed and compared using the Pearson's Correlation co-efficient. SPSS version 17 software was used and a P-value < 0.01 was regarded as statistically significant. RESULTS: Overall, there was a statistical significant positive correlation among most forms of assessment. The OSCE and the long case examination had a correlation of 0.374. Compared with the long case examination, the OSCE had a higher correlation with all other forms of assessment. The total clinical score (the sum of all long case examination and OSCE) however performed better than the OSCE or the long case examination alone as it had the highest correlation with all other forms of assessment. CONCLUSION: The OSCE has been shown to be better than the long case examination as an indicator of the student overall knowledge of surgery as it had a superior correlation with other forms of assessments. The total clinical score was however the best indicator of the student overall knowledge in Surgery as it had the best correlation with other forms of assessment. We recommend and encourage institutions that presently combine the OSCE and the long case examination to carry out similar analysis such as ours to determine the desirability of combining LCE and OSCE rather than outright replacement of LCE with OSCE.

Anaemia Prevention In Pregnancy Among Antenatal Clinic Attendees In A General Hospital In Lagos.

BACKGROUND: Anemia is the world's second leading cause of disability and thus one of the most serious global public health problems. The World Health Organization (WHO) estimates that an average of 56% of pregnant women in developing countries, are anaemic. OBJECTIVES: This study was conducted to. determine the knowledge, attitude and practices of prevention of anaemia in pregnancy amongst pregnant women attending the Antenatal Clinic at Ifako-Ijaiye General Hospital. METHODS: The design was cross-sectional descriptive study. Simple random sampling method was used to select two hundred and twenty respondents (220). A pretested, structured, interviewer administered questionnaires were used for data collection. RESULTS: Majority (95%) of the respondents was aware of anemia in pregnancy but the mean knowledge score was 56.5%. Less than half (46.3%) of the respondents thought that contraceptives could help prevent anemia in pregnancy by reducing closely spaced pregnancies. Only 31.8% were compliant with the use of iron supplements. About one third (33.2%) didn't combine drinking tea with meals while 47.3% of the respondents didn't use iron supplements with milk products. CONCLUSION: The study showed that most of the respondents had a moderate level of knowledge, and positive attitude towards contraceptive use but a high proportion were not compliant with the daily use of iron supplements. It is recommended that health education of women as well as close family members should be reinforced to improve the compliance with supplements.

Effect of health education on the knowledge and attitude to sickle cell disorder and screening practices among school of nursing students in Sokoto, Nigeria.

BACKGROUND: Sickle cell disorder is the most important genetic hematological disease that affects people of black African descent. The years of young adulthood present a good opportunity for screening and counseling for this genetic blood disorder. OBJECTIVES: To assess effect of health education and provision of free sickle cell haemoglobin screening on knowledge of sickle cell disorder, attitude towards sickle cell haemoglobin screening, and uptake of sickle cell haemoglobin screening among students of a School of Nursing. METHODS: Study design was a quasi-experimental noncontrolled study. Self-administered questionnaire was used for pre- and post-intervention data collection. Implemented interventions were seminar on sickle cell disorder combined with free sickle cell haemoglobin screening. The data was analyzed with Epi-info version 3.5.1 statistical software package. RESULTS: Respondents who participated in all the study phases were 104. Mean knowledge score (%) was high (80.9 +/- 22.8%) at baseline and improved significantly to 91.8 +/- 9.4% (p < 0.001) at post intervention. 91.3% were willing to screen fiancée before getting married while 72.1% were willing not to go ahead with marriage if self and fiancée are carriers of sickle cell haemoglobin. Phenotype of the respondents that volunteered to be screened for sickle cell haemoglobin were: A (70.5%), AC (6.8%) and AS (22.7%). CONCLUSIONS: Implemented interventions, seminar on sickle cell disorder combined with free sickle cell haemoglobin screening service yielded significant impact on respondents' knowledge, attitude and uptake of sickle cell haemoglobin screening.

Effect of health education on knowledge, attitude and practices of personal hygiene among secondary school students in rural Sokoto, North West, Nigeria.

BACKGROUND: Personal hygiene related diseases are serious public health problems in developing countries. OBJECTIVE: To assess the effect of health education on knowledge, attitude, and practices of personal hygiene among rural secondary school students in Sokoto state, north western Nigeria. METHODS: A quasi-experimental controlled study with pretest and post-test design was carried out. A total 120 subjects per group were selected by multistage sampling technique. Two pre-tested instruments, structured interviewer-administered questionnaire and observer's checklist for personal hygiene practices were used for data collection. Health education intervention was carried out one week after baseline data collection and repeated after four weeks for the intervention group only. Postintervention data collection was carried out in both intervention and control groups three months after the 2nd intervention. However, for ethical consideration, the control group was also provided with the health education intervention similar to that provided to the intervention group. RESULTS: A total of 120 and 116 subjects in the intervention and control groups respectively participated in all phases of the study. The mean knowledge score (%) of the study subjects was high and similar (73.18 +/- 25.82; 77.06 +/- 21.79; p = 0.21) in both the intervention and control groups at baseline, but differed very significantly (91.16 +/- 11.03; 81.74 +/- 21.78; p < 0.0001) at post-intervention. The mean attitude score (%) was high but differ significantly (82.6 +/- 12.73; 86.38 +/- 10.74; p = 0.01) between the intervention and control groups at baseline, and further differed very significantly (95.5 +/- 3.66; 86.90 +/- 10.44; p < 0.0001) at post intervention. The mean reported practice score (%) was high but differ significantly (94.86 +/- 3.00; 93.25 +/- 6.31; p = 0.01) between the intervention and control groups at baseline, and further differed very significantly (96.68 +/- 4.08; 93.7 +/- 6.28; p < 0.0001) at post-intervention. The mean observed practice score (%) was high and similar (57.50 +/- 29.65; 61.35 +/- 28.49; p = 0.31) in both the intervention and control groups at baseline, but differed very significantly (88.20 +/- 9.99; 62.10 +/- 26.94; p < 0.0001) at post-intervention. CONCLUSION: Health education intervention had impact on knowledge base, attitude and practice of study subjects in intervention group compared to control group. Personal hygiene health education is therefore recommended to be taught in secondary schools.

Pattern and outcome of cases seen at the Adult Accident and Emergency Department of the Lagos University Teaching Hospital, Idi-Araba, Lagos.

BACKGROUND: The accident and emergency department constitutes one of the vital entry points of patients into the healthcare facility of the hospital the world over. It responds to and manages variety of cases in all the clinical areas and thus pr vides an insight to the quality of care available in the health institution. OBJECTIVE: The aim of this study is to determine the pattern of cases seen as well as the causes of deaths at the adult accident and emergency department of the Lagos UniversityTeaching Hospital, Idi-Araba, Lagos. METHODS: Retrospective review of records of all patients attended to at the adult accident and emergency department of the Lagos University Teaching Hospital in 2009 and 2010 was carried out. Data spread sheet was used to collect data on demographic indices, diagnosis, outcome, date admitted, date discharged and amount paid from casualty attendance register and Nurses' report books. Data was collated and analysed using Epi-Info version 3.4.1 statistical software package. RESULTS: Out of the 5,427 available patients' records reviewed, 4,761(87.7%) were recorded as "discharged alive", 546 (10.1%) were recorded as "died", while 120 (2.2%) were recorded as "brought in dead". Of those discharged alive, male attendance was 2,376 (49.10%) while that of the female was 2,385 (50.10%). Majority of these patients were aged 20-39 years and the mean age of the patients was 39.96 +/- 18.22 yrs. Majority of cases seen were medical in origin (53.7%) and highest medical case seen was cerebrovascular accident, Commonest cause of death was from medical cases [69.2%] (cerebrovascular accident 22.0%). Male mortality was 55.3% while female mortality was 44.7%, mean age was 46.86 +/- 17.61. Most affected age group was 40 - 59 years (35.4%) and highest number of death was seen in December. CONCLUSION: The commonest case seen as well as commonest cause of death was cerebrovascular accident. A high number of heart failure, head injuries, road traffic accidents, upper gastrointestinal bleeding and post partum haemorrhage were also seen as common causes of death.The emergency physician must be well trained in skills required for the immediate management of patients with these cases.