Neonatal care - what do mothers in a rural Nigerian community know and practice?

BACKGROUND: Nigeria ranks among developing countries with poor neonatal health indices. This underscores the need for households and healthcare providers to understand the concept of newborn care and react appropriately and timely too. OBJECTIVE: To determine the knowledge and practices of mothers in the Elele community regarding neonatal care. MATERIALS AND METHODS: This was a community-based descriptive cross sectional study of 380 mothers who had a neonate. Mothers were selected using a multistage sampling technique. Data were collected by interview using a semi-structured questionnaire (with closed and open ended questions) and analyzed using a statistical package for social sciences version 22.0. Chi-square test was used to identify statistically significant associations among antenatal care clinic (ANC) attendance cum place of delivery and neonatal care practices. RESULTS: Ninety one (23.9%) of respondents were aware of at least four out of nine danger signs, while all reported wrapping their babies within 10 minutes after birth. Duration less than six hours from birth to first bath, feeding with or discarding of colostrum and timing of first breastfeeding within the first hour of birth were significantly associated with ANC attendance (p = 0.000, p = 0.002 and p = 0.000 respectively). Duration less than six hours to first bath, umbilical cord care and feeding with or discarding of colostrum were significantly associated with health facility delivery (p = 0.043, p = 0.026 and p = 0.003 respectively). CONCLUSIONS: Inadequate knowledge of newborn care among mothers was found, while non-ANC attendance and non-health facility delivery were associated with inappropriate neonatal care practices. We recommend comprehensive behavior change interventions, to promote proper neonatal care practices.

Evaluation of hormonal changes in menstrual cycle of women infected with pulmonary tuberculosis in Nnewi, south eastern Nigeria.

BACKGROUND & OBJECTIVE: The present study was designed to evaluate the hormonal changes in menstrual cycle of premenopausal women infected with pulmonary tuberculosis in Nnamdi Azikiwe University Teaching Hospital Nnewi. MATERIAL AND METHODS: A prospective study involving sixty-seven (67) female participants within the child-bearing age were randomly recruited and grouped based on their tuberculosis status as: Symptomatic TB infected females (n=20), Symptomatic TB infected females on ATT (n=20) and Control females (n=27). After due consent, a detailed medical history was obtained and routine investigations of pulmonary tuberculosis and confirmation using Ziehl Neelsen and sputum culture techniques for AFB and chest x-ray were done. Blood samples collected from the participants were used for hormonal assay using immunoenzymometric method. RESULTS: The results showed that the serum levels of FSH and LH (IU/ml) were significantly higher while progesterone and estradiol were significantly lower in Symptomatic TB females compared to Symptomatic TB females on ATT at follicular and luteal phases of menstrual cycle (P<0.05). The serum levels of FSH and LH were significantly reduced in Symptomatic TB females on ATT while progesterone and estradiol were significantly increased at follicular and luteal phases of menstrual cycle (P<0.05). FSH was significantly higher at follicular phase while estradiol was significantly higher at luteal phase of menstrual cycle in Symptomatic TB females on ATT. CONCLUSION: Tuberculosis induced hypogonadism in affected women which seemed to be reversed on treatment. Routine investigation for Tuberculosis should be done for women presenting with infertility, since early treatment can reverse the abnormality.

Parents' perceptions of timing of initiation of sexuality discussion with adolescents in Anambra State, South Eastern Nigeria.

STUDY OBJECTIVE: This study was aimed at determining the perception of the timing and practice of sexuality discussion among parents in South Eastern Nigeria. DESIGN: A cross-sectional, descriptive, community-based study. SETTING: The study was carried out in 3 randomly selected Local Government Areas in Anambra State, South Eastern Nigeria. PARTICIPANTS: The study participants were parents with adolescent children resident in the study areas for at least 2 years. RESULTS: Most parents opined that sexuality discussion should be initiated after puberty. Only 20% of them discussed reproductive health issues often with their adolescents, while another 20% never discussed such issues with their adolescent children. Topics most commonly discussed bordered on the adverse consequences of sex rather than measures for preventing them. About half of parents were willing to discuss contraception with their adolescent child. Predictors of parent-child communication were age, gender, and educational status. CONCLUSION: Common reasons for low parental involvement in sexuality discussions were due to their lack of capacity and the perception that discussing such issues before puberty is ill timed. Therefore, measures should be taken to improve the capacity of parents to engage in such conversations to provide sexuality information to their teens.

Prevalence and pattern of bacteria and intestinal parasites among food handlers in the Federal Capital Territory of Nigeria.

BACKGROUND: In developing countries, biological contaminants largely bacteria and other parasites constitute the major causes of food-borne diseases often transmitted through food, water, nails, and fingers contaminated with faeces. Accordingly, food-handlers with poor personal hygiene could be potential sources of infections by these micro-organisms. OBJECTIVE: This study was aimed at determining the prevalence and pattern of bacteria and intestinal parasites among food handlers in the Federal Capital Territory. MATERIALS AND METHODS: The study was a descriptive one in which a multistage sampling technique was employed to select 168 food handlers of various types. Subjects' stool, urine, and fingernail analyses were carried out and the result scientifically scrutinized. RESULTS: FINGERNAIL BACTERIA ISOLATES INCLUDE: E. Coli (1.8%), coagulase-negative staphylococcus (17.9%), Staphylococcus aureus(7.1%), Klebsiella species (2.4%), Serratia species (1.2%), Citrobacter species (1.2%), and Enterococcus species (1.8%). The subjects' stool samples tested positive: For A. lumbricoides (14.9%), T. trichuria (1.8%), S. starcolaris (3.0%), E. histolytica (10.7%), G. lambilia (1.8%), S. mansoni (1.2%), and Taenia species (4.8%). Furthermore, 42.3% and 15.5% of the stool specimen tested positive for Salmonella and Shigella species, respectively. CONCLUSION: Food establishments should screen and treat staff with active illness, and regularly train them on good personal and workplace hygiene practices.

Proximate determinants of antenatal care utilization among women in southeastern Nigeria.

BACKGROUND: In order to scale up Antenatal services, there is need to determine the factors that deter women from accessing antenatal care. AIM: To determine the proximate factors that affect utilization of antenatal care among market women in Nnewi, southeastern Nigeria. MATERIALS/METHOD: A cross sectional survey of 400 market women using semi structured questionnaires and focus group discussions. RESULT: Out of the 398 studied women, 97.2% attended antenatal care in their last pregnancy. Most (64.5%) of them booked after the third trimester and majority of the women received antenatal care from the private specialist hospitals (37.4%), followed by the private general practice hospitals (34.7%) and government hospitals (17.8%). The main reasons for choosing antenatal care facilities were the perceived friendliness of the staff (33.9%), availability of staff always (27.4%) and proximity of the facility (17.4%). Financial considerations accounted for 4.5% of the reasons for the choice of facility. There was no significant influence of age, parity and religion on the utilization of antenatal care. However, the likelihood of ANC attendance was significantly lower among the house wives (x2 = 14.2; p = 0.0). There was no association between choice of facility for ANC and age, parity, occupation or religion. The main reasons identified by the FGD discussants for preferring the private hospitals were more friendly and available staff. Also late booking was mainly attributed to wrong advice from friends and husbands refusal to provide money. Antenatal care attendance rate was high among the studied women and most of the women utilize private hospitals for care. Staff friendliness and availability at all times were the main reasons for choice of ANC facilities. There is the need to address the negative attitudes of the staff in government hospitals.

Determinants of subjective health status of HIV positive mothers in NAUTH Nnewi.

BACKGROUND: Acquired immune deficiency syndrome (AIDS) caused by human immune deficiency virus (HIV), once dominated by infected males has become feminized especially in sub-Saharan Africa where the majority of adults living with the condition are females. Positive life styles, belonging to social support groups and stigma-free HIV services by providers may have good impact on the quality of life of HIV-positive mothers. This study was aimed at assessing the determinants of subjective health status of HIV-positive mothers accessing prevention-of-mother-to-child-transmission (PMTCT) of HIV services in Nnamdi Azikiwe University Teaching Hospital (NAUTH) Nnewi. METHODS: This is a descriptive study in which 288 consenting HIV positive mothers were selected using the systematic sampling technique. Data on demographics, life style, social support, contraceptive use and subjective feeling about current health status were collected from the subjects using a pre-tested, structured, interviewer-administered questionnaire. RESULTS: The mean age of the respondents was 30.46 +/- 4.86 years. Majority (89.2%) of them were married while 55.2% were traders. A significantly higher proportion of the mothers on highly active anti retroviral therapy (HAART) (70.8%) than non users (29.2%) described their current health status as 'excellent' (p<0.001). Also a significantly higher proportion of condom users (99%) than pill users (1%) described their health status as 'excellent' (p<0.02). The same significantly higher proportions of 'excellent' response were given by subjects who engage in social support activities (p<0.001), who practice good feeding (p<0.01) andpersonal hygiene (p<0.01). CONCLUSION: Access to family planning services and HAART, participation in support group activities and positive lifestyle practices tend to improve subjective health status and should be comprehensively encouraged among the HIV positive mothers.

Prevalence and Pattern of Bacteria and Intestinal Parasites among Food Handlers in the Federal Capital Territory of Nigeria

Background: In developing countries; biological contaminants largely bacteria and other parasites constitute the major causes of food-borne diseases often transmitted through food; water; nails; and fingers contaminated with faeces. Accordingly; food-handlers with poor personal hygiene could be potential sources of infections by these micro-organisms. Objective: This study was aimed at determining the prevalence and pattern of bacteria and intestinal parasites among food handlers in the Federal Capital Territory. Materials and Methods: The study was a descriptive one in which a multistage sampling technique was employed to select 168 food handlers of various types. Subjects' stool; urine; and fingernail analyses were carried out and the result scientifically scrutinized. Results: Fingernail bacteria isolates include: E. Coli (1.8); coagulase-negative staphylococcus (17.9); Staphylococcus aureus(7.1); Klebsiella species (2.4); Serratia species (1.2); Serratia species (1.2); Citrobacter species (1.2); and Enterococcus species (1.8). The subjects' stool samples tested positive: For A. lumbricoides (14.9); T. trichuria (1.8); S. starcolaris (3.0); E. histolytica (10.7); G. lambilia (1.8); S. mansoni (1.2); and Taenia species (4.8). Furthermore; 42.3 and 15.5 of the stool specimen tested positive for Salmonella and Shigella species; respectively. Conclusion: Food establishments should screen and treat staff with active illness; and regularly train them on good personal and workplace hygiene practices

Contraceptive choices and practices among urban women in southeastern Nigeria.

BACKGROUND: Determining the contraceptive choices among the women is the first step in scaling up family planning methods. OBJECTIVE: To determine the contraceptive choices and practices as well as the underlining factors among market women in Nnewi, southeastern Nigeria. SUBJECTS/METHOD: This is a cross sectional descriptive study of market women, that assessed their contraceptive choices and practices. RESULT: Knowledge about family planning was 96.5%. One hundred and seventy five (44.0%) of the interviewed women were currently using a family planning method while 59.0% had ever used a method. The common methods in use were the natural method (24.1%), withdrawal method (7.5%) and the IUCDs (6.1%). The commonest ever used method was the natural method (26.7%) followed by withdrawal method (10.6%) and condom (7.8%). Fear of family planning commodities interfering with future fertility was the commonest reason for non use of family planning services (14.6), followed by the fear of the side effects (10.6%). Seventy one (17.8%) of the non-users had no reason. The use of family planning services was significantly high among the women aged 35 and above (x2 = 9.98; P = 0.04) and the (x2 = 23.8; P = 0.00). Focus group discussions indicated that husband's refusal, fear of side effects, cancer and delayed fertility were the main barriers to the use of family planning methods. CONCLUSION: The contraceptive prevalence rate among Nnewi market women is high and cuts across all religions and social classes. However, the methods in common use are associated with high failure rates. The use of the more reliable methods should be encouraged.

Perception and care-seekling behaviour for post partum morbidity among mothers in Enugu south east, Nigeria.

BACKGROUND: Postpartum Care is necessary to monitor and ensure return to normal of some physiological changes that occurred during pregnancy and delivery, and any abnormalities detected should be treated. The aim of this study is to describe the perception of and care seeking behaviour for maternal morbidity following childbirth among mothers in Enugu, Nigeria and determine if they depend on the socio-demographic characteristics ofmothers. METHODS: A cross-sectional survey of women who had recent deliveries was done. Quantitative and qualitative methods of data collection were used. Data analysis was by descriptive and inferential statistics at 95% level of confidence and manual content analysis. RESULTS: Three hundred and seventy-one respondents who had, at least, one self-reported morbidity following childbirth were studied. Only approximately 43.1% perceived their symptoms as abnormal and 39.5% sought medical attention for their symptoms. Inaccurate perception was influenced by the severity of symptoms as well as cultural beliefs on what constitutes abnormal symptoms following childbirth. Correct perception of morbidity was dependent on maternal age (p = 0.002) and educational status (p = 0.004) whereas positive care seeking behaviour was dependent on area of residence (p = 0.03). A greater proportion of mothers aged 30 years or below had accurate perception compared to older mothers (p = 0.02). A greater proportion of rural dwellers sought medical attention for their symptoms compared to urban dwellers. CONCLUSION: Inaccurate perception of, and poor care seeking behaviour for postpartum morbidity were common among a sample of women with recent deliveries in Enugu due largely to cultural beliefs about morbidity following childbirth. Correct perception and positive care seeking behaviour were not enhanced by older age, greater educational attainment of mothers or residence in urban areas.

Gender perspectives of sexual and reproductive practices of people living with HIV/AIDS in Enugu, South East Nigeria.

BACKGROUND: a major focus of attention in the efforts at controlling the spread of HIV infection has become the role of gender inequality. The objective of the study was to compare the sexual practices of HIV-positive male and female patients who received counselling and treatment at an Anti-retroviral Clinic in Enugu, South-East Nigeria. METHOD: A comparative cross-sectional descriptive study of patients attending the free anti-retroviral clinic at the University of Nigeria Teaching Hospital Enugu was done. RESULTS: A total of 146 males (30.8%) and 328 females (61.9%) were studied. Although there was no significant difference in the prevalence of sexual activity between the sexes, the reasons for sexual practices differed. Females indulged in risky sexual activity principally in obedience to the demands of their male partners and were more likely to have sexual partners who were unaware of their seropositivity than males. CONCLUSION: Risky sexual behaviour among women living with HIV/AIDS in Enugu despite exposure to intensive counselling was still mainly driven by the subordinate traditional gender roles of women in this culture.

Gender Perspectives of Sexual and Reproductive Practices of People Living With HIV/AIDS in Enugu; South East Nigeria

Nigerian major focus of attention in the efforts at controlling the spread of HIV infection has become the role of gender inequality.1; 2 The objective of the study was to compare the sexual practices of HIV-positive male and female patients who received counselling and treatment at an Anti-retroviral Clinic in Enugu; South-East Nigeria. Method: A comparative cross-sectional descriptive study of patients attending the free anti-retroviral clinic at the University of Nigeria Teaching Hospital Enugu was done. Results: A total of 146 males (30.8) and 328 females (61.9) were studied. Although there was no significant difference in the prevalence of sexual activity between the sexes; the reasons for sexual practices differed. Females indulged in risky sexual activity principally in obedience to the demands of their male partners and were more likely to have sexual partners who were unaware of their seropositivity than males. Conclusion: Risky sexual behaviour among women living with HIV/AIDS in Enugu despite exposure to intensive counselling was still mainly driven by the subordinate traditional gender roles of women in this culture.: