Profile of non-accidental childhood injury at a tertiary hospital in south-west Nigeria.

BACKGROUND: Injury threatens children lives worldwide. Most studies from Nigeria have been on accidental injuries in children. OBJECTIVES: To study the profile of non-accidental injuries among children receiving care at a tertiary hospital in Nigeria. METHODS: Children with non-accidental injuries were serially recruited and studied. The Paediatrics Trauma Score (PTS) was tested against the outcome. RESULTS: Non-accidental injuries accounted for 0.84% of all 5264 patients and 21.3% of the 207 injured. The case fatality rate was 6.8%. Physical abuse, sexual assault, drowning/near drowning, gunshot, poisoning and human bite caused the injuries in 68.2, 13.6, 6.8, 4.5, 4.5 and 2.3%, respectively. One-way analysis of variance and Tukey post hoc analysis showed that the mean PTS score of patients who died was significantly lower than the scores of those who were either discharged home or who discharged against medical advice (p < 0.001). CONCLUSION: The burden of non-accidental childhood injuries was high in the study area.

Effects of stigmatization/discrimination on antiretroviral therapy adherence among HIV-infected patients in a rural tertiary medical center in Nigeria.

INTRODUCTION: Stigmatization and discrimination impact negatively on interventions and act as barriers to all HIV/AIDS activities. This study assessed the relationship between stigmatization and discrimination and adherence to antiretroviral therapy (ART) among HIV-infected patients attending the Federal Medical Centre, Ido-Ekiti, Nigeria. METHODS: A cross-sectional study was carried out among respondents selected by systematic random sampling. Structured, interviewer-administered questionnaires were used to collect data subsequently analyzed with SPSS 16. RESULTS: A total of 100 respondents comprising 61 (61.0%) female participants were interviewed. A large proportion, 92.0%, had a low level of stigmatization. In all, 88 (88.0%) had a good level of antiretroviral adherence using a threshold of >95%. More people living with HIV/AIDS (PLWHAs) with low stigmatization and discrimination had good adherence to ART (P < .001). CONCLUSION: The PLWHAs with low levels of stigmatization and discrimination are more likely to adhere to ART than those with high levels. Counseling services and health education on adherence should be a strong component of all PLWHA care.

Pattern and medical care of child victims of sexual abuse in Ekiti, south-western Nigeria.

BACKGROUND: Child sexual assault (CSA) is a global health problem which affects many children and is often under-reported in developing countries. Data on CSA are few in these countries. AIMS AND OBJECTIVES: This study aimed to review the pattern and medical care of victims of CSA in a tertiary hospital over a 39-month period. METHODS: This is a retrospective, descriptive study. Case files of 28 cases of CSA were retrieved from those of 6535 patients seen in the paediatric out-patient department of Ekiti State University Teaching Hospital between 1 January 2010 and 31 March 2013. RESULTS: Victims of CSA accounted for 0.43% of new patients seen during the period under review with a yearly increase over that time. Victims were all female with a median age of 11.5 years and the age range was 4-17. They all had genito-urinary findings and 3.6% had an anal tear. The assailants were all male, mostly adults. A school-teacher and school-friends were the perpetrators in 3.6% and 10.8% of cases, respectively. All were screened for HIV, but only 60.7% were screened for hepatitis B and C. Only 60.7% received HIV post-exposure prophylaxis and none was given prophylaxis against viral hepatitis B and C. Of those eligible for post-exposure emergency contraception, only 43.8% received it. Antibiotics and analgesics were routinely given in 89.3% cases. Only one of the patients attended for follow-up. None had repeat serological screening tests. The police were involved in 60.7% of cases but there was no prosecution. CONCLUSION: Perpetrators of CSA are protean and, in the study area, there are gross inadequacies in the care provided for victims. Standard treatment protocols and additional training for health-care providers involved in the management of CSA victims are required.