Prevalence and patterns of gender-based violence in Enugu, Nigeria: a cross-sectional study.

Introduction: gender-based violence remains one of the most persistent human rights abuse in the world and with the emergence of the COVID-19 pandemic and its attendant mitigating protocols; Gender-based violence (GBV) could be on the rise with changes in its pattern and presentation. The aim of the study was to determine the prevalence and patterns of GBV among victims presenting in a tertiary health facility in South-East Nigeria during the first phase of the COVID-19 pandemic. Methods: this was a retrospective cross-sectional study, among 710 victims of GBV, who reported and received care at the GBV unit in a tertiary hospital in Enugu, South-east Nigeria. A pro forma designed by the researchers was used to collect secondary data from GBV facility screening forms and folders of all patients that reported any form of GBV over a 3-year period (2018 - 2020). Results: majority (89.9%) of victims of GBV were females and over a half (51.4%) of the cases were in the age group 20-39 years. In total, 56.8% of the GBV cases had been sexually abused. The pattern of GBV over the three years period under study revealed an increase in proportion for both sexual and physical/emotional violence, with a peak in 2019 and a reduction of cases in 2020. Persons below 19 years of age were 23 times more likely to experience sexual violence, than those between 40-59 years of age (AOR: 23.332; 95% CI: 11.037 -49.325) p<0.001. Males were 11 times more likely to experience physical/emotional violence than females (AOR: 11.136; 95% CI: 4.685-26.471) p<0.001. Age, gender, urban dwelling and year of occurrence were significant predictors of GBV. Conclusion: GBV is a cause for concern in Enugu Nigeria; affecting mainly young female victims in their prime. There is an increase in reported cases of GBV in Enugu Nigeria with sexual abuse being more prevalent.

Paediatric HIV: Correlation between Serum Zinc Levels and CD4 Percentage on Asymptomatic Nigerian Children Living with HIV.

OBJECTIVE: This study was conducted to determine the relationship between their serum zinc levels and the CD4% in a cohort children living with HIV. METHODS: One hundred asymptomatic, anti-retroviral Therapy (ART) naïve children living with HIV (participants) aged 5-60 months who were enrolled into the Paediatric HIV clinic of The University of Nigeria Teaching Hospital were recruited in the study over a 10-month period. Blood samples were collected in the morning from non-fasting participants and serum zinc levels were analysed using Atomic Absorption Spectrophotometer. The CD4% was ascertained using the CD4% easy count kit on the Partec® Cyflow Counter machine. Data were analysed using Statistical Package for the Social Sciences version 19. RESULT: The median (IQR) serum zinc level for the participants was 55.5 µg/dl (49.75) while their median (IQR) CD4% was 27.79% (18.67). Males had a median (IQR) CD4% of 24.29% (19.10) which was significantly lower than those of females [32% (20.59) (p = 0.047)]. No significant relationship was found between CD4% and zinc levels among the subjects (r = -0.061, p = 0.557). CONCLUSION: Serum zinc levels of asymptomatic ART naïve children living with HIV have no relationship with their CD4%.

Awareness, acceptability and uptake of cervical cancer vaccination services among female secondary school teachers in Enugu, Nigeria: a cross-sectional study.

INTRODUCTION: cervical cancer is a major cause of morbidity and mortality in women and vaccination of adolescents with human papilloma virus (HPV) vaccines is a major preventive strategy for this cancer. Despite the usefulness of cervical cancer vaccines, significant gaps still exist in the level of awareness and acceptability of the vaccine among women. This study aimed to determine the level of awareness, acceptability, and identify the factors associated with the uptake of this vaccine by female secondary school teachers in Enugu, Nigeria. METHODS: a cross-sectional study of 377 female teachers in Enugu metropolis was undertaken between July and October 2017. A structured interviewer-administered pretested questionnaire was used for data collection and SPSS used for analysis. RESULTS: less than half (41.9%) of the respondents had good knowledge of the cervical cancer vaccine. The majority of the respondents (93.6%) accepted the vaccine and will recommend it for their children and students. Only 14.6% and 9.0% of the respondents have taught their students about cervical cancer or HPV vaccines and had a programme in their school that addresses cervical cancer or cervical cancer vaccination respectively. Only 3.4% of the respondents have been vaccinated while 5.6% of their children or relatives have received the HPV vaccine. Previous vaccination of participants (p = 0.000), existing programmes addressing cervical cancer in schools of respondents (p = 0.000), participants having taught students about cervical cancer (p = 0.025) and high economic status (p = 0.013) significantly increased the likelihood of participants vaccinating their adolescent daughters/relatives. Extremes of age (p = 0.001) and being the head of their families (p = 0.002) significantly reduced the likelihood of the daughters/relatives to be vaccinated. Only previous history of vaccination of the respondents predicted the vaccination of their children and relatives (AOR = 6.069; 95% CI; < 0.0001-0.041). CONCLUSION: the overall knowledge of the HPV vaccine was low but the acceptability was high among respondents who were aware of the vaccines. Vaccine uptake among children/family members of the respondents was low. The introduction of cervical cancer vaccination education of the teachers in the secondary schools will help improve cervical cancer vaccination and the uptake among adolescent´s populations in the country.

Distracted Driving and Cell Phone use by Nigerian Road Users: A Cross-sectional Study.

Background: This study ascertained the level of distraction attributable to cell phone by drivers in Enugu. Methodology: This study was conducted in Enugu, Nigeria using a validated structured questionnaire randomly administered to drivers in different locations in the city. Study period was 2 months and different forms of distraction while driving were tested. Result: There were 500 participants in the study. 306(61.2%) were males and 194(38.8%) were females. The mean age of respondents was 43.85±9.89 years. Ninety-nine percent of respondents were aware of the ban on use of cell phones while driving but as much as 97.8% of the drivers still use cell phones while driving. Conclusion: Level of distracted driving in Enugu is quite high and this has the potential to cause serious road crashes which can impact negatively on the lives of the people. The need for concerted effort to educate people on the dangers of cell phone use while driving cannot be over emphasized. Key Lessons: - There is a paucity of literature on distracted driving in Nigeria even with the high incidence of Road Traffic Accident.- Awareness of laws on distracted driving is not the challenge rather it is compliance. There is need for ways of enforcing the existing laws on distracted driving as mere knowledge of the provisions of the law does not ensure compliance.- Enforcement of laws on distracted driving will play a preventive role in reducing the incidence of RTAs and its associated health implications.

Use of Probiotics in the Management of Acute Watery Diarrhoea in Nigerian Children: How Effective are S. Boulardii only Preparations?

Background: Diarrhoeal diseases are a major cause of death worldwide particularly among under-fives and probiotics is used in the management of diarrheal diseases. While some probiotics are of unproven usefulness, others are. Despite the burden of diarrhoea diseases in Africa, there is paucity of studies to support the efficacy or otherwise of S. boulardii among children with diarrheal disease. This study examined the impact of S. boulardii on the clinical course of acute watery diarrhea in children in a tertiary hospital in Nigeria. Methodology: Two hundred and fifty under-five children with acute watery diarrhoea were recruited and treated in the hospital. One hundred and twenty-five were given probiotics (S. boulardii) in addition to Oral Rehydration solution (ORS), zincand antibiotics while the other one hundred and twenty-five were noton probiotics (Controls). Their stool frequency on the 3rd and 5th day and the duration of the diarrhea, were used to assess outcome. Information was obtained using a questionnaire and then analysed. Result: Majority of the children (58.8%) were at their second half of infancy (7-12 months). The average number of diarrheal episodes was significantly lower among the subjects by the 3rd day of intervention (t = 2.496, p = 0.013) but not by the 5th day (t = 0.212; p = 0.832). Duration of diarrhea, however, was not significantly different between the subjects and controls (p = 0.246). Conclusion: S. Boulardiionly probiotic preparations reduce the number of diarrhoeal episodes but not the duration of diarrhea among under- 5s.

Hydrostatic reduction of intussusception in children: a single centre experience.

INTRODUCTION: intussusception is a common surgical emergency in children especially in infants. Treatment of intussusception could be non-operative or operative. Non-operative treatment (hydrostatic reduction) of intussusception is increasingly being practiced in developing countries. METHODS: this was a review of our experience in the hydrostatic reduction of intussusception in children at a teaching hospital in Enugu, Nigeria. This study covered an 18-months period, October 2017 to March 2019. Patients on presentation were resuscitated, appropriate investigations done and prepared for surgery before the hydrostatic reduction (using normal saline) was carried out. Patients with features of peritonitis and marked abdominal distension were excluded from hydrostatic reduction. RESULTS: twenty patients who had 21 episodes of intussusception were analyzed. One patient had a recurrence that necessitated repeat hydrostatic reduction. Eighty percent of the patients were male. The mean and peak age of the patients was 8 months and 6 months respectively. Significant number of the patients presented after 48 hours of onset of their symptoms. Abdominal pain was the predominant presenting symptom. Twenty percent and fifteen percent of the patients had a history of preceding gastrointestinal and respiratory infections preceding the intussusception respectively. Ileocolic intussusception was the most common type and the most distal end of the intussusception was at the transverse colon. Hydrostatic reduction was successful in 13 patients (65%). CONCLUSION: hydrostatic reduction is a simple and effective method of treatment of intussusception. However, early presentation and proper patient selection is necessary for optimal outcome.

Snakebite in children in Nigeria: A comparison of the first aid treatment measures with the world health organization's guidelines for management of snakebite in Africa.

Background: Snakebite and envenomation remains a public health problem with significant morbidity and mortality in children in developing countries. The World Health Organization (WHO) in 2010 developed guidelines for the prevention and management of snakebite in Africa. Aim: The aim of this study was to compare the pattern of first aid treatment among children presenting with snakebite/envenomation with the 2010 WHO guideline for the prevention and clinical management of snakebite in Africa. Patients and Methods: All children who presented with snakebite over a 7-year period in a teaching hospital in Enugu, Nigeria. The first aid treatment given to these children was obtained and was compared with the provisions of the WHO guideline for the prevention and clinical management of snakebite in Africa (2010). Data collected were analyzed using SPSS version 22. Results: Five (71.4%) of the snakebites occurred in the rainy season and in the dark involving the lower limbs in 85.7% of cases. Six (87.5%) of the patients received one form of first aid before presentation to a health facility. None received first aid interventions in line with the WHO recommendation. Topical application of herbal concoctions to the site of the bite (37.5%) was the most common intervention. One (14.3%) of the children was promptly brought to the health facility following snakebite. The interval from bite to presentation to the health facility ranged from 1 to 12 h (median 5 h: 43 min). Conclusion: Huge gaps still exist in the first aid treatment given to snakebite victims compared to the WHO guidelines.

RésuméContexte: La morsure de serpent et l'envenomation demeurent un problème de santé publique avec une morbidité et une mortalité importantes chez les enfants des pays en développement. L'Organisation mondiale de la Santé (OMS) a élaboré en 2010 des lignes directrices pour la prévention et la gestion des morsures de serpent en Afrique. Objectif: L'objectif de cette étude était de comparer le modèle de traitement des premiers soins chez les enfants présentant des morsures de serpent/envenomation avec la directive 2010 de l'OMS pour la prévention et la prise en charge clinique des morsures de serpent en Afrique. Patients et méthodes: Tous les enfants qui se sont présentés avec des morsures de serpent sur une période de 7 ans dans un hôpital d'enseignement à Enugu, Nigeria. Le traitement de premiers soins accordé à ces enfants a été obtenu et a été comparé aux dispositions de la ligne directrice de l'OMS pour la prévention et la prise en charge clinique des morsures de serpent en Afrique (2010). Les données recueillies ont été analysées à l'aide de la version 22 du SPSS. Résultats: Cinq (71.4%) des morsures de serpent se sont produites pendant la saison des pluies et dans l'obscurité impliquant les membres inférieurs dans 85,7% des cas. Six (87,5 %) des patients ont reçu une forme de premiers soins avant d'être présentés à un établissement de santé. Aucun d'entre eux n'a reçu d'interventions de premiers soins conformément à la recommandation de l'OMS. Application topique des concoctions à base de plantes sur le site de la morsure (37,5%) était l'intervention la plus courante. Un (14,3%) des enfants a été rapidement amené à l'établissement de santé à la suite d'une morsure de serpent. L'intervalle allant de la morsure à la présentation à l'établissement de santé variait de 1 à 12 h (médiane 5 h : 43 min). Conclusion: Il existe encore d'énormes lacunes dans le traitement des premiers soins accordé aux victimes de morsures de serpent par rapport aux lignes directrices de l'OMS.

A Comparison of the Academic Performance and Intelligence Scores of Asthmatic and Nonasthmatic Primary School Pupils in Enugu State, Nigeria.

BACKGROUND: Children with asthma (subjects), just as their non asthmatic colleagues, are expected to perform optimally academically and with a good intelligent score. A number of activities in children with asthma may be affected by asthmatic attacks including their education/academic performance. Report on academic performance and IQ of school children with asthma and comparisons with those without asthma (controls) within and outside Nigeria are scanty. AIMS: This study compared the academic performance and IQ of asthmatics and nonasthmatic school children. MATERIALS AND METHODS: One hundred and twenty children with asthma aged 5-11 years were consecutively recruited at the asthma clinic of UNTH Enugu and their age, gender and socio-economic class-matched normal classmates were enrolled as controls. Academic performance of the children with asthma was studied using the overall scores achieved in the three term examinations in the preceding academic year (2012/2013), while their IQ was determined using the Draw-A-Person-test. The findings were compared with that of the 120 controls. RESULTS: The median (range) overall academic scores for the subjects 79.04% (36.08%-99.57%) was similar to that of controls 80.01% (50.65%-97.47%) (U = 6804, P = 0.461). However, a significant number of subjects compared to controls had poor academic performance. The mean IQ scores for subjects (123.28 ± 21.45) and controls (118.41 ± 19.87) did not differ significantly (t = 1.83; P = 0.069). There was also a significant and negative correlation (Pearson's) between age and mean DAPQ in both the subjects and controls (r = -0.377, P < 0.001; r = -0.492, P < 0.001 respectively. CONCLUSIONS: The intelligence scores and overall academic performance of children with asthma compares favorably with that of children without asthma.