The rate and cost of hospitalisation in children with sickle cell anaemia and its implications in a developing economy.

BACKGROUND: There is paucity of data on the cost and rate of hospitalization in children with sickle cell anaemia (SCA) in most developing nations. OBJECTIVE: To estimate the rate and cost of hospitalization in children with SCA in Nigeria and evaluate the economic burdens on their families. METHODS: The number and duration of hospitalizations; estimated aggregate family's monthly income, cost of care and percentage of the mean annual income spent on hospitalization for each respondent were obtained using a structured questionnaire. RESULTS: The mean age of the 73 children was 61.1(44.3) months; M:F was 1:1.6. They had 183 admissions (average of 2.5(1.9) admissions per child per year). The mean family monthly income was $250.37, while the average cost of care per hospitalization per subject was $132.67. The total cost of care during the year was $24,278.37. About one-third of the caregivers spent at least 10% of their estimated annual income as total cost of hospitalization. CONCLUSION: The rate and the cost of hospitalization for children with SCA and the percentage of income spent on hospitalization were too high in our environment. Government should strengthen the National Health Insurance Scheme and subsidise the cost of care to these children.

Assessment of the sexual functions of males with chronic liver disease in South West Nigeria.

BACKGROUND: Patients with chronic liver disease (CLD) have been reported to have sexual dysfunction irrespective of etiology. There is little or no report from Nigeria on this disorder. This study looked at sexual dysfunction among male patients with CLD. MATERIALS AND METHODS: Patients with chronic viral hepatitis B, liver cirrhosis (LC) and hepatocellular carcinoma (HCC) were interviewed using the international index of erectile function questionnaire. Their responses were compared with an age and sex matched healthy controls. Bio-data and body mass index were obtained for both groups and liver disease severity was graded for patients using the Child-Pugh score. Analysis was done using SPSS (SPSS Inc., Chicago, IL, USA, 2004) for frequencies and means while comparison of means was done using Student's t-test. Significance level was put at P < 0.05. RESULTS: There were 120 subjects consisting of 60 patients aged from 28 to 71 years; mean (SD) 45. 3 ± 9.4 and 60 controls aged from 29 to 79 years with mean (SD) 45.5 ± 10.1 years. Sexual dysfunctions were seen in patients with HCC and LC in the domains of sexual desire and sexual satisfaction respectively when compared with controls. When patients were divided into the various liver disease severities, patients in Child-Pugh Grade B scored low in the domain of arousal, whereas the domains of erectile functions, orgasm, resolution and satisfaction were affected in patients in Grade C when compared with controls. CONCLUSIONS: Male patients with CLD have significant sexual dysfunctions when compared with controls. The dysfunctions are more pronounced in those with Grade C liver disease. Sexual concerns of CLD should be inquired of in those with advanced liver disease.

The effect of caesarean section on self-esteem amongst primiparous women in South-Western Nigeria: a case-control study.

OBJECTIVE: This study aims to assess the level of self-esteem of newly delivered mothers who had caesarean section (CS) and evaluate the sociodemographic and obstetrics correlates of low self-esteem in them. METHODS: Newly delivered mothers who had CS (n = 109) and who had spontaneous vaginal delivery (SVD) (n = 97) completed questionnaires on sociodemographic and obstetrics variables within 1 week of delivery. They also completed the Rosenberg self-esteem scale. RESULTS. Women with CS had statistically significant lower scores on the self-esteem scale than women with SVD (p = 0.006). Thirty (27.5%) of the CS group were classified as having low self-esteem compared with 11 (11.3%) of the SVD group (p = 004). The correlates of low self-esteem in the CS group included polygamy (odd ratio (OR) 4.99, 95% confidence interval (95% CI) 1.62-15.33) and emergency CS (OR 4.66, 95% CI 1.55-16.75). CONCLUSIONS: CS in South-Western Nigerian women is associated with lowered self-esteem in the mothers.

The unmet need for contraception among Nigerian women in the first year post-partum.

OBJECTIVE: To determine the level of Unmet need for Contraception among women in the first year post-delivery in Ile-Ife, Nigeria. METHODS: A prospective study of 256 women attending antenatal clinic of the OAUTHC, Ile-Ife, Nigeria was carried out 9-10 months post-delivery. Using a semi-structured questionnaire, the respondents were interviewed for socio-demographic characteristics; obstetric, sexual, and contraception history were also taken. The data were analyzed using descriptive and inferential statistical methods. RESULTS: There was a high level of unmet need (59.4%) in the sample of Nigerian women despite a high level of awareness of common methods of contraception. Education and parity had no significant effect on usage of contraception (p > 0.05). No reason was given for non-usage in the largest proportion (30.3%) of the non-users. Only one-third of the respondents could correctly report the 'at-risk' period for getting pregnant in the post-partum period. CONCLUSION: There is a need to study in more detail the social and cultural factors that determine contraceptive utilization before success can be achieved in closing the gap of unmet need, as it has become evident that increasing the awareness and knowledge of contraception is not enough to achieve the objectives of family-planning programs.