Cervical Cancer and Human Papillomavirus Vaccine Knowledge, Utilisation, Prevention Educational Interventions and Policy Response in Nigeria: A Scoping Review.

PURPOSE: This review evaluated the knowledge, utilisation, prevention education, and policy response across the six geopolitical regions of Nigeria to inform national efforts for the prevention and control of cervical cancer. METHODS: A keyword-based systematic search was conducted in PubMed/MEDLINE (NCBI), Google Scholar, and AJOL electronic databases, including a manual scan of papers, journals and websites to identify relevant peer-reviewed studies. Articles were screened and assessed for eligibility. RESULTS: Many (158) articles were downloaded and after duplicates were removed, 110 articles were included in the final analysis. These were made up of qualitative, quantitative (cross-sectional), intervention and policy studies. Studies have generally reported poor knowledge and awareness of cervical cancer screening but those carried out in urban areas demonstrated a slightly higher level of awareness of Human Papilloma Virus (HPV) vaccine, HPV vaccination uptake and utilization of cervical cancer preventive services than the rural studies. The studies did not show strong government support or policies in relation to cervical cancer control. CONCLUSION: Knowledge and uptake of cervical cancer preventive services across diverse groups in Nigeria remain poor. These could be linked to socio-cultural factors, the lack of an organised cervical cancer screening programme and low financial resource pool for cervical cancer prevention. Therefore, it is necessary to increase government, donor prioritisation and political support in order to ensure increased investment and commitment to cervical cancer elimination in Nigeria.

Indepth Interviews' on Acceptability and Concerns for Human Papilloma Virus Vaccine Uptake among Mothers of Adolescent Girls in Community Settings in Ibadan, Nigeria.

Human papillomavirus (HPV) vaccine offers protection of between 80 and 100% for anogenital warts and 60-80% in reducing the incidence of pre-malignant lesions from cervical cancer. However, uptake remains low in Nigeria among adolescent girls. This study was a qualitative study that assessed mothers' acceptability and concerns regarding uptake of HPV vaccine by their adolescent daughters. In-depth interviews were conducted with 20 mothers of adolescents girls aged 9-15 years. A snowballing sampling technique was adopted to select the mothers within the community. Consent was obtained for the use of audiotapes, which were transcribed verbatim with thematic analysis of data. Mothers were between the ages of 30-49 years and most of them were traders. Almost all of the women have heard about cervical cancer, but their knowledge about cervical cancer and HPV vaccine was low. Despite their low knowledge, most of the mothers accepted that the vaccine is good and was willing for their adolescent daughters to take the HPV vaccine for the prevention of HPV. However, cost of the vaccine, side effects, and potential exposure of their daughters to promiscuity after taking the vaccine for protection were the major concerns expressed by the mothers as regards to HPV vaccine uptake by their daughters. Findings highlight the need for health promotion and education programs about cervical cancer, HPV, and HPV vaccine to increase awareness and knowledge among mothers of adolescent girls. Also, HPV vaccination should be included as part of routine immunization for female adolescents.

Experience of Stress and Coping Mechanism Among Police Officers in South Western Nigeria.

Prior research on stress among police officers in Nigeria is limited. Most researchers have focused on the predictors of workplace stress among the police officer, and fewer still have examined their coping mechanisms. This study assessed the stress experienced and coping mechanism among police officers in Ibadan Metropolis, Oyo State, Nigeria. The study was a descriptive cross-sectional study, which utilized a pretested self-administered questionnaire. The study population included 342 selected respondents using a multistage sampling technique from police stations in Ibadan North Local Government, Oyo State, Nigeria. The data were analyzed using descriptive statistics, χ2 test, and Fisher's exact test at p = .05. Results revealed that majority (92.5%) of the respondents had poor knowledge of stress with a mean knowledge of 5.4 ± 1.7. Majority (80.1%) of the respondents reported experience of stress such as feeling depressed sometimes at work, while 60.5% said that they usually have headache and body ache. In addition, 36.9% had good coping mechanism and more than half (58.8%) had a fair coping mechanism with a mean coping score of 5.0 ± 3.0. This study showed that knowledge of stressors was poor and respondents perceived that they experienced stress and its symptoms. Strategies such as training using teaching, discussion, and explanation to educate the police officers about stress and its coping mechanism and policy interventions to facilitate the construction of standard stress management centers would be appropriate strategies to reduce stress, increase the knowledge of police officers on stressors, and enhance their coping mechanism.

Access to Information on Family Planning and Use of Modern Contraceptives Among Married Igbo Women in Southeast, Nigeria.

This study was conducted among married Igbo women in Nigeria who have the lowest median birth interval coupled with a culture of sex preference and low use of modern contraceptives. We examined the relationship between access to information on family planning and sex preference on the use of modern contraceptive (MC). The 2013 Nigeria Demographic and Health Survey data were used. The data of 1,661 women of reproductive age were analyzed in this study. Access to information on family planning was low, and almost half (48.6%) of the women had a score of zero. Controlling for possible confounding variables, the data show that women who have good (odds ratio [ OR]= 3.92; CI [2.28, 6.75], p < .001) and poor ( OR = 2.56; CI [1.85, 3.56], p < .001) access to information on family planning were more likely to use MC than those with no access to information on family planning. Sex preference showed no relationship with the use of MC. Families where husbands want more children than their wives inhibit ( OR = 0.62, CI [0.42, 0.90], p < .05) the use of MC compared with those families where husbands and wives fertility desire is the same. Public health programs by government and donors should intensify interventions to increase access to family planning information to promote the use of MC among married Igbo women.

Maternal Education and Diarrhea among Children aged 0-24 Months in Nigeria.

Childhood diarrhea remains a problem in countries like Nigeria where access to potable water, good hygiene and sanitation are lacking. Maternal education is an important determinant of health status of under-five children. Very few studies have investigated the relationship between maternal education and diarrhea in children in Nigeria. Therefore, this study was implemented to fill the gap. The study design was cross-sectional and 2013 National Survey was used. Children aged 0-24 months were investigated and the dependent variable was diarrhea status of the index child in the last two weeks prior the survey. The main independent variable was maternal education. Data were analyzed using Chi-square and Logistic regression models (α=0.05). Diarrhea prevalence was 13.7% and higher (15.5%) among children of women who have no formal education, and mothers living in the North East region of Nigeria experienced the highest prevalence (26.4%). Children whose mothers had no formal education were 2.69(CI= 1.800-4.015, p <0.001) more likely to have diarrhea as compared to those who had higher education. Maternal education is an important predictor of diarrhea among children aged 0-24 months in Nigeria. Policies to reduce diarrhea among children in Nigeria should target children of the illiterate, less educated mothers and those living in the North-West.

Outcome of a reproductive health advocacy mentoring intervention for staff of selected non-governmental organisations in Nigeria.

BACKGROUND: Non-governmental organisations (NGOs) are expected to be in the vanguard, repositioning reproductive health as a central issue in population and development in Nigeria. However, most of them have insufficient knowledge or access to policy and planning processes necessary at engaging effectively with the government. This article highlights the processes and outcome of an intervention aimed at strengthening the capacity of 12 non-governmental organisations on advocacy and policy related activities with emphasis on reproductive health issues. METHODS: The study employed a one group, pre and post test study design. Thirty six (36) staff from 12 NGOs was purposively selected and interviewed using a semi-structured questionnaire at baseline to assess their knowledge and level of involvement in reproductive health, advocacy and policy issues. In-depth interviews were conducted with 6 officials of the ministries of health and women affairs to document previous reproductive health and policy related collaborative efforts with the NGOs. Baseline findings were used in developing and implementing a capacity building intervention. A post intervention evaluation was conducted to assess the outcomes. RESULTS: All respondents (100%) had tertiary level education and were from a multidisciplinary background such as nursing (41.7%) medicine (25%) and administration (13.9%). The mean knowledge score on advocacy and policy issues at pre-test and post test was 39.1 ± 17.6 and 76.2 ± 14.2 respectively (p = 0.00). Participants reported making use of advocacy methods and the three most utilized were Phone calls (28.1%), Face to Face meetings (26%) and networking with other organisations for stronger impact (17.1%). The outcome of their advocacy efforts include the provision of free air time by a television station to educate the populace on maternal health issues, donation of landed property to build a youth friendly centre, donation of a blog site for disseminating information on Reproductive health issues and training of other staff of their organisations on advocacy activities. The major challenges experienced by staff of the NGOs were financial (89%) and time constraints (11%). CONCLUSION: Empowered non-governmental organisations can effectively advocate for the implementation of reproductive health policies and programmes.

Genome-wide association analyses of breast cancer in women of African ancestry identify new susceptibility loci and improve risk prediction.

We performed genome-wide association studies of breast cancer including 18,034 cases and 22,104 controls of African ancestry. Genetic variants at 12 loci were associated with breast cancer risk (P < 5 × 10-8), including associations of a low-frequency missense variant rs61751053 in ARHGEF38 with overall breast cancer (odds ratio (OR) = 1.48) and a common variant rs76664032 at chromosome 2q14.2 with triple-negative breast cancer (TNBC) (OR = 1.30). Approximately 15.4% of cases with TNBC carried six risk alleles in three genome-wide association study-identified TNBC risk variants, with an OR of 4.21 (95% confidence interval = 2.66-7.03) compared with those carrying fewer than two risk alleles. A polygenic risk score (PRS) showed an area under the receiver operating characteristic curve of 0.60 for the prediction of breast cancer risk, which outperformed PRS derived using data from females of European ancestry. Our study markedly increases the population diversity in genetic studies for breast cancer and demonstrates the utility of PRS for risk prediction in females of African ancestry.

Using genome and transcriptome data from African-ancestry female participants to identify putative breast cancer susceptibility genes.

African-ancestry (AA) participants are underrepresented in genetics research. Here, we conducted a transcriptome-wide association study (TWAS) in AA female participants to identify putative breast cancer susceptibility genes. We built genetic models to predict levels of gene expression, exon junction, and 3' UTR alternative polyadenylation using genomic and transcriptomic data generated in normal breast tissues from 150 AA participants and then used these models to perform association analyses using genomic data from 18,034 cases and 22,104 controls. At Bonferroni-corrected P < 0.05, we identified six genes associated with breast cancer risk, including four genes not previously reported (CTD-3080P12.3, EN1, LINC01956 and NUP210L). Most of these genes showed a stronger association with risk of estrogen-receptor (ER) negative or triple-negative than ER-positive breast cancer. We also replicated the associations with 29 genes reported in previous TWAS at P < 0.05 (one-sided), providing further support for an association of these genes with breast cancer risk. Our study sheds new light on the genetic basis of breast cancer and highlights the value of conducting research in AA populations.

Urban Poor Community Settings' Knowledge and Screening Practices for Cervical Cancer in Ibadan, Nigeria.

PURPOSE: This study investigated knowledge and screening practices for cervical cancer among two urban poor community settings in Ibadan, Nigeria. METHODS: A cross-sectional design was used. ODK tool was used to collect quantitative data among a sample size of 500 respondents. Data were analyzed using IBM SPSS version 21 for descriptive and inferential statistics. Scores for knowledge were on a scale of 0-39 points (0-18 low, 19-23 fair, and 24-39 high knowledge). RESULTS: A majority of respondents (77.2%) had low knowledge of cervical cancer and were not aware (93.6%) of the Papanicolaou test (Pap smear test) or cervical cancer screening (91.2%). Very few women (10%) were aware of the human papillomavirus vaccine for the prevention of cervical cancer, 4% had been screened with the Papanicolaou test, and one woman (0.3%) with visual inspection with acetic acid. Four (1.1%) women had taken human papillomavirus vaccine before. CONCLUSION: The findings of this study have underscored a necessity for increased awareness creation through health promotion interventions and strategies to alleviate low knowledge, prevention, and screening practices for cervical cancer in poor community settings in Nigeria.