SURVEY OF SEXUAL ACTIVITY AND CONTRACEPTIVE USE AMONG UNMARRIED YOUNG SCHOOL AND COLLEGE DROP-OUTS IN A DEFINED NIGERIAN POPULATION.

This study sought to characterize sexual behaviour, contraceptive use and contributory upbringing factors among young people who had dropped out of school or college in a Nigerian setting. A community-based, cross-sectional sexual survey of 161 young people aged between 15 and 35 who had dropped out of school or college was performed in Ado-Ekiti, south-west Nigeria, in April 2015. One hundred and nineteen of the respondents (73.9%) had had sexual intercourse. Mean age at sexual debut was 19.08±3.5 years. Of those with sexual experience, 79 (66.4%) had their sexual debut with a previous boy/girlfriend and 33 (27.7%) had it in their current relationship. Three (2.5%) respondents had first sex with a stranger. About 90% were still having sexual intercourse within 12 months of the survey; more males had had sex than females (81.1% versus 67.8%). Around 80% of those with sexual exposure practised a form of contraception, mainly use of the male condom, but fewer than 25% were all-time contraceptive users. Coming from a single-parent family (p=0.04) or from a family of poor economic status (AOR: 7.41; 95% CI: 0.69-0.83) were found to be associated with sexual debut by the age of 19 and premarital sex, respectively, in these young people. Unprotected sexual intimacy was found to be high among young school/college drop-outs in this region of Nigeria. This group of young people need targeted reproductive health intervention as they represent a potent route for HIV transmission in the region.

Post-partum urinary retention in a teaching hospital in southwestern Nigeria.

AIM: This study was undertaken to determine the prevalence of post-partum urinary retention after vaginal delivery and to examine the associated risk factors. MATERIAL AND METHODS: This was a prospective observational study carried out over a 2-month period at the major university teaching hospital in southwestern Nigeria. RESULTS: Prevalence of post-partum urinary retention was 29.4%. The majority (93.3%) of women had covert urinary retention while 6.7% had overt urinary retention. From the bivariate analysis, episiotomy, reduced voiding desire and primiparity were risk factors for post-partum urinary retention (66.6% vs 30.6%; P = 0.017; 47.75% vs 13.9%; P = 0.037; and 60.0% vs 30.6%; P = 0.05; respectively). CONCLUSION: Post-partum urinary retention, particularly covert retention, is a common complication of labor and delivery in our clinical practice but is rarely reported in the published work, especially from this part of the world. No factor has been found to be independently associated with its occurrence, hence there is need for vigilance in the immediate post-partum period as most cases of urinary retention would have been avoided if women were encouraged to void early following delivery.

Why do married women procure abortion? Experiences from Ile-Ife, south western Nigeria.

BACKGROUND: In Nigeria, about 1.25million induced abortions occur annually and the country accounts for one-fifth of abortion-related deaths globally. OBJECTIVES: The study aimed to assess the determinants of induced abortion among married women. METHODS: A mixed methods study was conducted in Ile-Ife, Nigeria. The quantitative component employed a cross-sectional study design while the qualitative aspect comprised focus group discussions. Information on contraceptives use, unintended pregnancy and induced abortion were obtained from 402 married women (with at least one child) aged 18-49 years using a semi-structured questionnaire. Four focus group discussion sessions were conducted among women of reproductive age. RESULTS: Majority (67.2%) of respondents had ever used a contraceptive method. However, 34.3% of the women have had unintended pregnancies and 14.2% had induced abortion. FGD findings revealed that non-use of contraceptives and contraceptive failure were major reasons for unintended pregnancies and induced abortion. The significant predictors of induced abortion were non-use of contraceptives, age≥ 40 years and multiparity. CONCLUSION: Induced abortion still occur among married women particularly those not using contraceptives, aged ≥40 years and those with high parity. More emphasis should be placed on making contraceptives more accessible to married women.

Eight-hour versus 24-h urethral catheter removal following elective caesarean section for reducing significant bacteriuria: A randomized controlled trial.

BACKGROUND: There is no consensus on the preferred time to remove urethral catheter post caesarean section. AIM: To compare rate of significant bacteriuria and urinary retention following 8-h (study) and 24-h urethral catheter removal (control) post elective caesarean section. METHODS: A randomized controlled trial of eligible participants that underwent elective caesarean section under spinal anaesthesia between March 2019 and November 2019 was conducted. Participants (150 in each arm) were randomly assigned (1:1 ratio) to either 8-h or 24-h group. Primary outcome measures included rates of significant bacteriuria 48-h post-operatively and acute urine retention 6-h post urethral catheter removal. Analysis was by Intention-to-treat. (www.pactr.org:PACTR202105874744483). RESULTS: There were 150 participants randomized into each arm and data collection was complete. Significant bacteriuria was less in 8-h group (3% versus 6.0%; risk ratio (RR): 0.85 CI: 0.60 to 5.66; p = 0.274), though not significant. Acute urinary retention requiring repeat catheterisation was significantly higher in 8-h group (11(7.3%) versus 0(0.0%); RR: 0.07; CI: 0.87 to 0.97; p = 0.001). Mean time until first voiding was slightly higher in 8-h group (211.4 ± 14.3 min versus 190.0 ± 18.3 min; mean difference (MD): 21.36; CI: -24.36 to 67.08; p = 0.203); but patient in this group had a lower mean time until ambulation (770.0 ± 26.1 min versus 809 ± 26.2 min; MD: -38.8; CI: -111.6 to 34.0; p = 0.300). The 8-h group were significantly more satisfied (82/150 (54.7%) versus 54/150 (36.0%); p = 0.001). CONCLUSIONS: An 8-h group was associated with significant clinical satisfaction and acute urine retention compared to 24-h removal. The timing of urethral catheter removal did not affect rate of significant bacteriuria and other outcomes.