Parametric survival analysis of menarche onset timing among Nigerian girls.

BACKGROUND: This study was a response to the dearth of information on the timing of menarche in low-income countries, and the need to update knowledge on the condition. It thereby enables the provision of adequate support to young girls during menarche. The study determined the timing and range of onset of menarche and identified the factors influencing the timing. METHODS: We used data on girls' sexual and reproductive processes from a nationally representative population survey of girls aged 15-24 years in Nigeria. Descriptive statistics, and survival analysis techniques were used for data analysis at p = 0·05. FINDING: A quarter of the respondents (26%) had commenced menstruation by age 12. Almost all, (90%) had experienced menstruation by age 17. Girls aged 20-24 years reported later menarche (time ratio 1·066, 95% CI: 1·045-1·087) compared to those aged 15-19 years. An increase of respondents age by one year resulted in 0·8% delay in onset timing. Significant differences were also found in the zone of residence among the sampled population. Compared with girls from the South East, the timing of menstruation was generally delayed among the girls from South-South by 5%, North Central by 9%, South West by 10%, North East by 16% and 17% among girls from the North West. INTERPRETATION: There was a wide range in menarcheal age in Nigerian girls with a peak at 13-14 years and the possibility of a secular trend in the timing of onset. Early family life education is recommended.

PATRONAGE AND COST OF MALARIA TREATMENT IN PRIVATE HOSPITALS IN IBADAN NORTH L.G.A SOUTH WESTERN, NIGERIA.

BACKGROUND: Malaria accounts for about 60% of all clinic attendance in Nigeria. About 300,000 children die of malaria annually while an estimated 4,500 pregnant women are lost annually on account of malaria in Nigeria alone. High cost of treatment is a barrier to the uptake of health services in low resource settings, therefore an exploration of the cost of malaria management will reveal possible components that may benefit from intervention and thus reveal important clues for improving access to malaria treatment. Objective of this study therefore is to describe patronage and cost of malaria treatment in private hospitals in Ibadan. METHOD: This was a descriptive cross sectional study, carried out in private hospitals in Ibadan, South Western Nigeria. A self-administered questionnaire with open and close-ended questions was used to collect data on patronage and cost of treatment in adults, children and pregnant women attending private health facilities in Ibadan, Nigeria. Data were presented using tables of frequencies and proportions while analysis was by descriptive statistics. RESULTS: A total of 40 doctors and hospitals participated in the study. Average patronage for malaria, both complicated and uncomplicated per month was 153 patients per hospital. Malaria cases accounts for 331 (46.2%) of total clinic cases seen in private hospitals in a month. About 121 (78%) of malaria cases seen were uncomplicated while 32 (21%) of cases were complicated malaria. Average amount charged patient for treating uncomplicated malaria in private hospitals was N3,941. Average amount spent on antimalarial drugs was about N2,443 (62%) while N1,064 (27.7%) was spent on laboratory investigation and N406.00 (10.3%) for medical consultation. CONCLUSION: Drugs cost constitute the bulk of expenses on malaria treatment. Policy makers may improve access to malaria treatment by subsidizing the cost of anti-malaria drugs for pregnant women and children, who might not be able to afford treatment.

Compliance with infection control practices by Veterinarians in Nigeria.

BACKGROUND: There is a global increase in morbidity and mortality due to zoonotic diseases hence there is a need to identify possible sources of infections to human population. This study assessed veterinarians' compliance with standard infection control practices (ICPs) for prevention of zoonosis in Nigeria. METHODOLOGY: A cross sectional survey of 320 veterinarians participating in the National Annual Conference of the Nigerian Veterinary Me ic Association was done in November, 2011 Characteristics related to compliance with standard infection control practices were assessed. Chi-square and logistic regression tests were done at 0.05 significant levels. More veterinarians (51.1% and 61.2%) did not comply with appropriate ICPs while carrying out medical procedures of necropsy and assisting in parturition. Those with longer years of practice (OR=0.42,95% CI=0.23-0.75) and with long working hours (OR=0.52, 95% CI=0.28-0.97) were less likely to comply with ICPS. Private practice veterinarians' were less likely than public practitioners to comply (OR=0.67, 95% CI = 0.15-0.69). Also veterinarians who had workplace IC policy were more likely than those without to be compliant with ICPs (OR=3.71, 95% CI = 1.87-7.37). CONCLUSION: Future conferences can be used to advise veterinarians on the importance of implementing appropriate IC measures. Also infection prevention practices laws and policies should be enacted to encourage compliance by veterinarians.

EXPERIENCE OF INTIMATE PARTNER VIOLENCE AS A PREDICTOR OF SEXUALLY TRANSMITTED INFECTIONS AMONG MARRIED WOMEN IN NIGERIA.

BACKGROUND: Intimate partner violence (IPV) is an important public health issue that is associated with adverse sexual and reproductive health outcomes including sexually transmitted infections (STIs). STIs have recently gained more recognition worldwide because they increase the risk for HIVinfection. However, there is dearth of information on the association between IPV and STIs particularly among married women in Nigeria. OBJECTIVE: To determine the association between IPV and STIs among married women in Nigeria. METHOD: This was a secondary data analysis of the 2008 Nigeria Demographic and Health Survey (NDHS) dataset. A total of 18,402 married women aged between 15 and 49 years were included. Questions about intimate partner violence were adapted from the Conflict Tactic Scale (CTS). Multiple logistic regression models were used to determine relationship between IPV and self-reported STIs. RESULTS: The prevalence of IPV among married women in Nigeria was 29.3%. Majority of the women experienced emotional violence (22.1%), 17.3% of the women experienced physical violence while the least experienced form of violence was sexual IPV (4.4%). Majority (60.1%) of the women experienced just one type of IPV, 30.0% two types, 9.9% all three types. The prevalence of self-reported sexually transmitted infections was 7.2%. Logistic regression demonstrated that after controlling for other covariates, women who experienced any form of IPV were found to be more likely to report STI than women who did not [OR 1.357 (95% CI 1.188-1.551)]. In addition, experience of physical and sexual IPV was significantly associated with history of STIs [OR 1.699 (95% CI 1.420-2.034); OR 1.414 (95% CI 1.085-1.843) respectively]. Experiencing two or more types of IPV was significantly associated with history of STIs [OR 1.759 (95% CI 1.446-2.139); OR 2.193 (95% CI 1.636-2.941) respectively]. CONCLUSION: There is a need to incorporate IPV screening and services in STI clinics. Also, it is important to screen for STIs among women who present with IPV particularly those with multiple types of violence.

Knowledge of hazards of antibiotics self-medication by mothers for under-fives in rural community of South-west Nigeria.

BACKGROUND: In Nigeria, self-medication of young children is common. Children under the age of five are often self-medicated with antibiotics because of their increased susceptibility to infections. OBJECTIVES: To assess mothers' knowledge on the hazards of antibiotics self-medication in a rural community of South-west Nigeria. METHODOLOGY: A community-based, cross-sectional study was conducted among 513 mothers selected through a purposive sampling technique from Koko community in Olodo, Ibadan between October and December, 2014. Data were collected using a semistructured interviewer administered questionnaire and analyzed with SPSS version 20. Descriptive statistics, Chi-square test and logistic regression were done at 5% level of significance. RESULTS: A very high proportion (96.5%) of mothers in this study practiced antibiotic self-medication for their children. Only 28.1% were knowledgeable about the risks and side effects of antibiotic self-medication. Chi-square test revealed that there was a significant association between respondents' educational status (P < 0.05) and knowledge of the hazards. Mothers with no formal education were less likely to be knowledgeable compared to those who had tertiary education (OR = 0.08; 95% CI = 0.02- 0.57). CONCLUSION: High proportions of mothers lack adequate knowledge on the hazards of antibiotics self-medication. Mothers, particularly those with lower educational levels and young age need to be educated on the risks and side effects of this practice.

Sexual behaviour and use of electronic media among undergraduates in the University of Ibadan.

BACKGROUND: Sexual behaviour among the youth contributes largely to the burden of reproductive health problems in Nigeria. This may have been worsened by the introduction of electronic media like internet and television (TV). However, little is known about the effects of electronic media on sexual behaviour of youth in Nigeria. Therefore, exploring the influence of effect of electronic media on sexual behaviour of youth may help policy maker to provide interventions to these problems. Thus, this study was aimed at assessing the effect of electronic media on sexual behaviour of Undergraduates in the University of Ibadan. METHOD: This was an analytical cross-sectional study, using a multistage sampling method and data were collected through self-administered semi-structured questionnaire. Variables measured are socio-demographic characteristics, exposure to electronic media and sexual practices of youths. Frequency tables were generated, and data analyzed by logistic regression. RESULTS: Four hundred and thirty three questionnaires were returned out of 456 distributed, giving a response rate of 95%. Mean age of respondents was 18.75 (SD = 2.5) years. About 58.4% of males use the internet and 58.6% watch TV while 41.6% of female use the Internet and 41.4% watch TV. Watching sexually explicit program on internet increases risk of having premarital sex (OR = 3.1; CI = 1.2-7.7) while watching non sexually explicit programmes on T.V protects from having premarital sex (OR = 0.4 CI = 0.2-0.8). CONCLUSION: These observed influence of exposure to sexually charged materials on the internet and electronic media indicates the need for efforts to be directed to controlling access, of youths to these sexually explicit programmes on the internet and television programmes.

Prevalence and Correlates of Intimate Partner Violence among Male Civil Servants in Ibadan, Nigeria.

BACKGROUND: Intimate Partner violence (IPV) is one of the common forms of violence against women and is a global public health problem that transcends social, economic, religious and cultural groups. It is often perceived as a private problem or a normal part of life but it contributes greatly to morbidity and mortality. OBJECTIVE: To assess the prevalence and correlates of intimate partner violence by male civil servants in Oyo State Secretariat Ibadan, Nigeria. METHODS: A cross-sectional study was conducted using a multi-stage sampling technique. A total of 609 respondents completed a pre-tested self-administered questionnaire. Data were analysed using SPSS version 18 and STATA version 12. Chi-square statistic was used to test associations between categorical variables and predictors of perpetration of intimate partner violence were determined using logistic regression model at a level of statistical significance of 5%. RESULT: The mean age was 38.8±9.9 years and about 74.5% were married. The prevalence of IPV perpetration in the 12 months preceding the study was 66.0%. The prevalence of controlling behaviour was 52.2%, psychological abuse - 31.2%, sexual violence - 23.0%, and physical violence - 11.7%. The predictors of perpetrating any form of IPV included previous history of physical fight with another woman [OR: 2.4 (95% CI: 1.30-3.40)], having a negative attitude towards wife beating [OR 2.5 [95% CI: 1.85-3.42], childhood exposure to parental IPV [OR: 2.1 (95% CI: 1.30-3.41)] and use of alcohol [OR: 1.6 (95% CI: 1.14-2.15]. CONCLUSION: The different types of IPV were prevalent among the male civil servants, despite their educational status. Strategies to stop IPV should include male education to change attitudes that encourage violence in relationships to use of non-violent conflict resolution strategies. Education should also include the dangers of alcohol abuse and involvement in physical fights.

Orbito-Ocular Tumours in Ibadan, South-West Nigeria.

AIM: The aim of this study was to review the cases of orbito-ocular tumors in a single tertiary health facility, and determine changes in pattern of presentation. METHODS: Medical records of all patients with histologically confirmed orbito-ocular tumors between January 1992 and December 2011 in a tertiary center were reviewed. Patients' demographics, types of orbito-ocular tumor and their presentation were recorded. RESULTS: Records of 205 patients were analyzed with a male to female ratio of 1.1:1 and median age of seven years. Retinoblastoma was the most common tumor followed by ocular surface squamous neoplasia. Squamous cell carcinoma was the most common eyelid tumor while rhabdomyosarcoma was the most common orbital tumor. No case of melanoma was seen during the period. More than two thirds of patients had lost vision at presentation due to delay in seeking appropriate medical attention Conclusion: There appears to be a reduction in the cases of orbito-ocular tumors in Ibadan, however, there is little variation in the pattern of presentation. Encouraging early presentation to the appropriate health facility may possibly reduce the morbidity in these patients.

Comparison of clinical profiles and treatment outcomes between vagrant and non-vagrant mentally ill patients in a specialist neuropsychiatric hospital in Nigeria.

OBJECTIVE: Vagrant mentally ill patients are a highly marginalized group that receive limited care and attention from society. There is a dearth of information on the clinical status of this group in low-income countries. The aim of this study was to compare the clinical profiles and treatment outcomes between vagrant and non-vagrant mentally ill patients admitted to Aro Psychiatric Hospital, Abeokuta, Nigeria. METHOD: We conducted a retrospective review of clinical records charting vagrant and non-vagrant mentally ill patients treated over a five year period from January 2004 to December 2008. RESULTS: The medical records of 61 vagrant and 122 non-vagrant mentally ill patients were reviewed and compared. The vagrant patients were more likely to be older, unmarried and alone, poorly educated, unemployed or performing unskilled labour, and diagnosed with schizophrenia. This cohort was also more likely to have physical co-morbidities compared with the non-vagrant mentally ill patients. The median time to improvement among the vagrants (211.0 days) was significantly longer than for the non-vagrant patients (34.0 days) suggesting more intractable illnesses. Other factors found to prolong the time to improvement among all patients were old age, education, being single, unemployment, the diagnoses of schizophrenia, and substance abuse. CONCLUSION: The clinical profiles and treatment outcomes were poorer among the vagrant mentally ill patients, underscoring a need for more comprehensive healthcare resources directed to this patient group in Nigeria.

Evaluating the medical care of child sexual abuse victims in a general hospital in Ibadan, Nigeria.

OBJECTIVES: Evaluation of the medical care provided to victims of Child Sexual Abuse (CSA). DESIGN: A retrospective cross sectional study. SETTING: The general outpatient clinic of a 150 bed secondary health care facility in Ibadan, Nigeria. PARTICIPANTS: Children < 18 years who were treated as Victim's sexual assault. MAIN OUTCOME MEASURE: Investigations and treatment prescribed for CSA victims. RESULTS: The median age of victims was 12 years (range 3-17 years). All were females and 33.3% had attained menarche. Many (68.1%) had torn hymen; of these, 16.3 % also had vaginal lacerations and bleeding. Children>10 years more often had torn hymen (P<0.001). Vaginal swab microscopy was done in 84.0% of those with torn hymen. About 60% of victims had retroviral screening done (all were non reactive) the retroviral screening of the perpetrator was requested in only case. None of the patients received post exposure prophylaxis for HIV. Of those with signs of vaginal penetration who had also attained menarche 12.2% had emergency contraceptives prescribed. Treatment of victims consisted mostly of antibiotics--47.2% and analgesics--37.5% with only 15.3% of patients proffered any form of counselling. CONCLUSIONS: There is a still a huge gap between the health care needs of victims of CSA and the medical services provided for victims of CSA. The use of a treatment protocol and additional training for health care providers in the management of CSA victims is encouraged.

Population-based prevalence of abnormal cervical cytology findings and local risk factors in Ibadan, Nigeria: implications for cervical cancer control programs and human papilloma virus immunization.

OBJECTIVE: To investigate the prevalence of abnormal cervical cytological findings and local risk factors in Ibadan, Nigeria. STUDY DESIGN: All women aged ≥15 years in each household in Idikan, Ibadan, were invited to participate in a population-based study. Structured questionnaires were administered to all consenting women. Conventional cervical Papanicolaou smears obtained from sexually active women were classified using the 2001 Bethesda system. The diagnoses were correlated with sociodemographic data and risk factors. RESULTS: Of 2,870 women aged ≥15 years estimated to live in Idikan, 1,204 sexually active women consented to pelvic examination and cervical smears. Results were available for 1,104 women (mean age: 39.8 years). Mean ages at menarche, first sexual intercourse and first pregnancy were 16.1, 20.3 and 20.7 years, respectively. Cytological results were categorized into atypical squamous cells of undetermined significance and atypical glandular cells 22 (1.99%); low-grade 43 (3.89%) and high-grade squamous intraepithelial lesions (HSIL) 17 (1.54%); invasive cancer 2 (0.18%) and normal 593 (53.8%) and reactive changes 427 (38.7%). The prevalence of epithelial abnormalities is 7.6%. Significant host-related factors in those with HSIL and invasive cancer included older age (mean 56.2 years), high parity and gravidity, lack of formal education and being divorced (p < 0.05). CONCLUSIONS: This study provides prevalence data and local risk factors for abnormal cervical cytology in a Nigerian population, which will be useful for planning future cervical cancer control programs.

Prevalence of violence against pregnant women in Ibadan, Nigeria.

Women are at risk of violence at all stages of their life, including during pregnancy. Using a interviewer-administered questionnaire, 306 pregnant women were interviewed in two public secondary health facilities in Ibadan to compare prevalence and risk factors of VAW before and during pregnancy. Prevalence ofVAW a year before current pregnancy was 41.5% compared to 17.7% during pregnancy. Perpetrators before pregnancy were mostly relatives (22%), while during pregnancy, partners (64%). Major reasons for violence were "not obeying instructions" (33.3%) and "misbehaving" (26%). Education (OR 0.49; 95% CI 0.29-0.83) and polygamous union (OR 9.56; 95% CI 3.71-24.63) and consumption of alcohol (OR 7.19; 95% CI 0.04-0.53) were statistically significant a year before pregnancy. Mothers occupation (OR 0.19; 95% CI 1.05-4.49); type of union (OR14.13; 95% CI 6.13-32.59), alcohol consumption by partner (OR 6.06; 95% CI 0.05-0.54); and not wanting pregnancy (OR 3.53; 95% CI 1.20-9.30) were statistically significant in the index pregnancy. Hemorrhage (7.4% vs. 4.8%), abortion (1.9% vs. 1.2%), intrauterine death (3.7% vs. 1.2%) and premature labour (9.3% vs. 3.2%) were more often found in women who experienced VAW than those who did not, the latter was statistically significant (P < 0.05). Violence avoidance strategies included 'playing along' (51.3%) and 'praying' (21%). Pregnancy was protective against VAW. Empowerment of women through education and employment is crucial. Counselling on planning of families is also necessary. Screening for violence in pregnancy and close monitoring of the abused to ensure good obstetric outcome is recommended.

Menstrual characteristics of secondary school girls in Ibadan, Nigeria.

BACKGROUND: Disturbances of menstrual function are the commonest complaints among adolescents. Disorders of menstruation may have implications for future reproductive health. OBJECTIVE: To assess menstrual patterns among school girls in Ibadan, south-western Nigeria. METHODS: This was cross-sectional descriptive study in which 1,213 apparently healthy school girls were selected by multistage sampling technique in fifteen secondary schools from the five local governments within the metropolis. Information about details of menstrual experience was obtained with a self-administered questionnaire. RESULTS: The girls were aged between 9 and 23 years. Majority of respondents 768 (633%) experienced normal cycle length, 391 (32.2%) had short cycles; and 55 (4.5%) had cycle length greater than 35 days. Prevalence of normal cycles increased with increasing age; abnormalities of cycle length tended to decrease with increasing age (p < 0.01). The majority, 1,152 (95%), had normal menstrual loss. The majority 882 (72.7%) experienced dysmenorrhoea; severe dysmenorrhoea was reported by 154 (12.7%). Cycle length was not associated with presence of dysmenorrhoea (p > 0.05); 695 (57.3%) had symptoms of pre-menstrual syndrome. CONCLUSION: Prevalence of menstrual abnormalities among adolescent schoolgirls is high. More attention should be paid to identify and treat these menstrual morbidities.

Prevalence of refractive error and attitude to spectacle use among drivers of public institutions in Ibadan, Nigeria.

BACKGROUND: High rate of motor vehicle accidents' have been associated with poor vision. Studies on drivers from elsewhere other than health institutions have found abnormal visual acuities. The aim of this study is to determine prevalence of refractive errors and the attitude to spectacle wear among drivers of public institutions studied. METHODS: A cross sectional population study of all 99 motor vehicle drivers from the College of Medicine, University of Ibadan and University College Hospital (UCH) Ibadan between December 2003 and January 2004. RESULTS: The ninety-nine motor vehicle drivers in the study comprised of 67 (67.7%) from the College of Medicine, and 32 (32.3%) from the UCH. All were males, aged 38 to 60 years, mean 50.1 +/- (SD= 4.8 years). Proportion of drivers with refractive errors was 16.7% (95% CI, 16.6-16.8) but only 56.3% of these wear glasses while driving (others did not including 3 out 4 who were bilaterally visually impaired without glasses). Relative frequency of RTA among drivers was 16.2%, the risk was marginally higher among drivers with refractive error (OR 1.2, 95% CI: 0.4-3.7). The commonest refractive error was simple hypermetropia present in 15 eyes. Hypermetropia was associated with increasing age of drivers (p<0.05). Majority (97.7%) of the drivers were presbyopic but only 32 (32.3%) were current wearers of spectacles. CONCLUSION: Refractive errors were present in 16.7% of drivers studied. But 43.8% of these (3 out 4 of whom were bilaterally visually impaired without glasses) do not wear corrective lenses while driving. There is need for periodic visual screening exercise and eye health education on drivers.

Trends in clinical autopsy rate in a Nigerian tertiary hospital.

The benefits of autopsy in medical practice are undisputed. In spite of these benefits, autopsy rates worldwide are on a precipitous decline. This study aims to determine trends in autopsy rate in a Nigerian tertiary institution from 1984-2003.A retrospective study of the autopsies conducted between 1984 and 2003. The post mortem registers of the department of Pathology University College Hospital Ibadan were reviewed for records of autopsy over the two decades. A total of 30,899 deaths and 3385 autopsy requests were registered during the period of study, giving average annual deaths of 1626 and average annual autopsies of 178 respectively. Autopsy rates at the hospital declined from an average of 19% in 1984 to 3.6% in 2003. The decline affected all clinical departments and both sexes. The highest autopsy rate of 19.9% was in 1986, while the lowest rate of 3% was recorded in the year 2000. There has been a remarkable decline in hospital autopsy rate in the University College Hospital Ibadan over the last 2 decades. The decline affected both adult and pediatric patients, both sexes and all principal medical units. There is need for active involvement of all stake holders including clinicians, pathologists and family members of deceased patients in strategic measures aimed at reversing this trend. An investigation into the factors responsible for this decline with the view to improving the autopsy services in the hospital is also required.

How well equipped are healthcare facilities to manage childhood malaria? The situation in selected local government areas in South Western Nigeria.

Using a structured questionnaire, surveys were conducted in 55 of 123 primary and secondary healthcare facilities in 4 selected local government areas in Southwestern Nigeria. Heads of healthcare facilities (HCFs) surveyed include nurses (41.8%), medical officers (21.8%) and community extension workers (21.8%). Twenty five (45.5%) HCFs run special clinics for children. About one fifth (20.3%) of staff had received continuing education on management of malaria. Forty seven (85%) HCFs possessed and used national guidelines for management of malaria. Although 48.9% of HCFs had microscopes, fewer had microscope slides, lancets and Giemsa stain which are also required items for definitive diagnosis of malaria. Healthcare workers were not well informed on some aspects in the management of malaria. Selected healthcare workers from various categories attended a workshop where they were trained to correct inadequate knowledge, attitude and practice in the management of malaria. These workers were to train their colleagues on their return to their respective HCFs.

Calcium and phosphate levels in Nigerian children with malaria.

Calcium and phosphate levels were investigated in 39 children with malaria (six severe and 33 uncomplicated) and in 39 healthy children. Hypocalcaemia (calcium <2.13 mmol/L, adjusted for albumin level) was detected in 23.1% of malaria cases and in 5.1% of controls, and hypophosphataemia (<1 mmol/L) in 38.5% of cases and in 15.4% of controls. Mean (SD) calcium levels in cases [2.26 (0/15)] were similar to those in controls [2.24 (0.12)]. In Nigerian children, hypocalcaemia and hypophosphataemia are associated with malaria.

Parameters of nutrition in school girls in southwestern Nigeria.

OBJECTIVES: To document trends in parameters of nutrition in south-western Nigerian school girls in comparison with earlier reports and provide baseline data for future comparison. DESIGN: A cross-sectional study. SETTING: Fifteen secondary schools from the five local governments in Ibadan, Oyo State in south-western Nigeria. SUBJECTS: One thousand six hundred and seventy five apparently healthy female students aged between nine and twenty three years. RESULTS: One thousand six hundred and seventy three questionnaires were analysed. The mean age, mean height and mean body weight were 15.45 years +/- 2.06 (SD), 154.98cm +/- 8.4(SD) and 46.09kg +/- 8.8 (SD) respectively. The mean body fat was 11.12kg +/- 4.6 (SD); mean lean body mass (LBM) was 34.96kg +/- 4.6 (SD); mean total body water (TBW) was 25.17L +/- 3.3 (SD) and the mean body index (BMI) was 19.07kg/m2 +/- 2.7 (SD). Girls from upper socio-economic background had significantly higher values of anthropometric measurements and body composition for each age than lower socioeconomic class girls. Compared with their peers from another Nigerian city investigated two decades ago, girls in this study were significantly lighter and shorter. CONCLUSION: The study revealed a decline in nutritional parameters among adolescents. The implications of these findings for the reproductive health of Nigerian women are discussed. Serial studies to monitor trends in adolescents are recommended.

Efficacy of herbal remedies used by herbalists in Oyo State Nigeria for treatment of Plasmodium falciparum infections--a survey and an observation.

In the course of evaluating the contribution of phytomedicine to possible drug discovery of antimalarial drugs, an ethnomedical survey of specialized children traditional clinics was done. In the observational multi center study, efficacy of eight different herbal remedies, each consisting of 3-8 ingredients and administered by herbalists were investigated in clients enrolled in the six traditional clinics in Oyo (urban center) and Otu (rural center) of Oyo State, Nigeria. The clients, aged between six months and fifteen years with clinical symptoms of malaria were enrolled in the clinics of the herbalists, as their usual practice. Oral informed consents were obtained from their parents or guardians. Microscopic diagnosis of malaria infection was used to evaluate parasitaemia and validate efficacy of herbal remedies. Results of the analysis showed that, of the 163 clients of the herbalists, only 62 (30 from Oyo, 32 from Otu) had microscopically confirmed P. falciparum infection. Only results from 54 clients (29/30 (Oyo) and 25/32 (Otu) with P. falciparum infection could be evaluated. Plasmodium falciparum infection in 88% (23/29) of clients from Oyo responded to treatment with the herbal remedies while cure rate in clients from Otu was 42% (13/25). Parasite densities ranged from 171 to 53,613 parasites/microl blood and 87 to 36,209 parasites/microl blood in patients from Oyo and Otu respectively. The herbalists administered the remedies and Gossypium arboreum, Anarcadium occidentalis, Citrus medica, Phyllanthus amarus and Lippia multiflora were the main ingredients in the efficacious remedies. The herbalists gave detailed descriptions of each of the 8 herbal remedies proffered. The results confirm the efficacy of two of the eight herbal remedies, thereby validating the role of ethnomedicine as a possible source for the discovery of new chemotherapeutic agents in the treatment of P. falciparum malaria.