Influence of family size, household food security status, and child care practices on the nutritional status of under-five children in Ile-Ife, Nigeria.

Fertility pattern and reproductive behaviours affect infant death in Nigeria. Household food insecurity and poor care practices also place children at risk of morbidity and mortality. The objectives of this study were to assess the influence of family size, household food security status, and child care practices on the nutritional status of under-five children in Ile-Ife, Nigeria. The study employed a descriptive cross-sectional design. A semi-structured questionnaire was used to collect data from 423 mothers of under-five children and their children in the households selected through multistage sampling methods. Food-insecure households were five times more likely than secure households to have wasted children (crude OR = 5.707, 95 percent CI = 1.31-24.85). Children with less educated mothers were significantly more likely to be stunted. The prevalence of food insecurity among households in Ile-Ife was high. Households with food insecurity and less educated mothers were more likely to have malnourished children.

Influence of family size, household food security status, and child care practices on the nutritional status of under-five children in Ile-Ife, Nigeria

Fertility pattern and reproductive behaviours affect infant death in Nigeria. Household food insecurity and poor care practices also place children at risk of morbidity and mortality. The objectives of this study were to assess the influence of family size, household food security status, and child care practices on the nutritional status of under-five children in Ile-Ife, Nigeria. The study employed a descriptive cross-sectional design. A semi-structured questionnaire was used to collect data from 423 mothers of under-five children and their children in the households selected through multistage sampling methods. Food-insecure households were five times more likely than secure households to have wasted children (crude OR=5.707, 95 percent CI=1.31-24.85). Children with less educated mothers were significantly more likely to be stunted. The prevalence of food insecurity among households in Ile-Ife was high. Households with food insecurity and less educated mothers were more likely to have malnourished children (Afr J Reprod Health 2010; 14[4]: 123-132)

Impact of nutritional education on nutritional status of under-five children in two rural communities of south-west Nigeria.

OBJECTIVES: This study evaluated the impact of nutritional education on knowledge, attitude and practices (KAP) of mothers concerning infants and young children feeding and their children's nutritional status in two semi-urban communities of south-west Nigeria. MATERIALS AND METHODS: This is a community intervention study. We recruited 150 mothers of children aged 0-18 months independently from the intervention and control communities through a multi-stage sampling technique. We collected data with the aid of an interviewer-administered questionnaire at baseline and at six months after intervention from both communities to obtain information on feeding of infants and young children. In addition, we measured weights and heights of recruited children. Intervention involved group counselling of mothers and food demonstrations at designated health facilities. Data analysis for quantitative data was done using Epi-Info software, and for qualitative data, content analysis of major themes was used. RESULTS: Before intervention, recruited mothers and their children from the two communities were comparable in terms of all the parameters assessed (P>0.05 in all cases). After six months of intervention, mothers who had nutritional education demonstrated better knowledge and attitudes to key infant and young children feeding recommendations. There was also limited improvement in feeding practices. Mothers from the intervention community exclusively breastfed their infants longer with mean age at introduction of complementary foods at 5.3 months compared to 4.5 months in the control community (P<0.05), breastfed their children longer (P<0.05). However, there was no statistically significant improvement in the weight of their children. CONCLUSION: In this study, nutritional education of mothers only had positive impact on their level of KAP on infant and young children feeding.

Assessment of delays in receiving delivery care at a tertiary healthcare delivery centre in Nigeria.

This study reviewed the causes of delays when patients were admitted with obstetric emergencies in Ife-Ife, Nigeria.

Knowledge, attitudes and practices of the educated and non-educated women to cancer of the breast in semi-urban and rural areas of SouthWest, Nigeria.

OBJECTIVES: That women with cancer of the breast seek medical help late is a common occurrence in developing countries. We decided to see if education and environment play any role in this and in cancer screening. A semi-structured questionnaire was drawn to inquire about knowledge, attitude (beliefs) and practices of women to breast cancer and available cancer screening methods in their environment- particularly Self and Clinical Breast Examination. PATIENTS AND METHODS: The questionnaires, prepared in English and vernacular, were given to women and women relations seen in the surgical clinics and wards of Ladoke Akintola University Teaching Hospital, Osogbo and some primary health centers, for various ailments. Traders in market places and rural communities were included. RESULTS: Analysis was by SPSS, chi-square, percentage frequency and tested at probability level of 0.05. Eight hundred and thirty two respondents were collected. Six hundred and twenty five (72.2%) were from Semi-urban while 207(27.8%) were from the rural regions. The age range was between 15 and 72 years with a mean age of 30.89+/-11.58. The educational level showed that 304(36.4%) had tertiary education. Six hundred and four (72.6%) have previous knowledge of cancer of the breast, 149(17.4%) offered possible aetiological reasons, and 341(41.1%) have some knowledge of associated symptoms. Available screening methods of Self and Clinical breast examination was practised by 393(47.2%) of the respondents. One hundred and fifty five (32.3%) would give consent to mastectomy while as many as 619(74.4%) have deep fear of the disease. CONCLUSION: Despite a relatively high literate level in the study group, knowledge of aetiological causes of breast cancer, including risk factors is abysmally low; so is knowledge and attitude to symptoms. Because of this poor/inadequate knowledge, as well as available screening methods, efforts should be made to upgrade the knowledge of our women through Information, Education and Communication (I.E.C) on cancer of the Breast and the consequences of late presentation.

Blindness and visual impairment among the elderly in Ife-Ijesha zone of Osun State, Nigeria.

BACKGROUND: To provide information on the prevalence of visual impairment, blindness and the leading causes of visual changes among the elderly in Ife-Ijesha zone of Osun state in Nigeria. DESIGN: A cross-sectional descriptive community based study. METHODS: All people aged 60 years or older were gathered at various centres in Ife-Ijesha zone of Osun State, Nigeria. They were all screened for various medical problems including eye ailments and blindness according to World Health Organisation (WHO) definition. Information was retrieved and clinical examination conducted by the ophthalmologist in the team. Data collected were analyzed using descriptive statistical methods. RESULTS: Out of the 681 elderly who presented for medical check up, 445 had eye problems. A few 25 (5.6%) were bilaterally blind while 202 (45.4%) were visually impaired according to the WHO definition of blindness and visual impairment. Blindness was twice as common in men as in women and the difference was statistically significant (P=0.0001). Cataract (42.3%), glaucoma (32.4%) and uncorrected aphakia (9.9%) were the leading causes of blindness in 69 eyes while 80% of visual impairment was due to cataract alone. CONCLUSIONS: The prevalence of blindness and visual impairment in this study population is high. These findings in a community where most of the elderly are fast losing traditionally accorded attention due to civilization and urban movement call for a great concern.

Assessment of dietary knowledge, practices and control in type 2 diabetes in a Nigerian teaching hospital.

BACKGROUND: In spite of the importance of diet in the management of diabetes mellitus (DM), diabetics are often unaware of its place in ensuring good glycaemic control. Consequently, compliance and adherence with dietary advice remain poor among diabetics. The standard of practice of dietary therapy for DM among physicians is also low. The aim of this study therefore was to assess the dietary knowledge, practices and control of type 2 DM in Obafemi Awolowo University Teaching Hospitals' Complex, Ile-Ife, Nigeria. METHOD: All 33 type 2 diabetes patients that attended the hospital over a three month period were studied to assess knowledge of DM, dietary practice and control. Percentage perceived, correct and accurate knowledge as well as practice were used for comparative analysis. RESULTS: All 33 subjects had truncal obesity and needed to lose weight. This was moderately severe in 60% of subjects. About 52% received dietary advice. The latter had a significantly higher mean dietary knowledge score than those without dietary advice. Significantly higher mean knowledge scores seemed to be associated with better dietary practices and better glycaemic control. Overall, dietary practices improved significantly following diagnosis and counselling. A significant proportion of subjects increased their use of food with low glycaemic index (legumes 48.5%, cereals 90.9%) following diagnosis. CONCLUSION: The findings further emphasize the importance of structured dietary advice and dietary control in Type 2 diabetes. In settings where dieticians are scarce, physicians managing diabetic patients must be skilled in the dietary management of the condition and show commitment to it.

The under utilization of honey in a deprived environment.

The study investigated the utilization of honey in the treatment and prevention of illness amongst 400 respondents in Oranfe Community, Ile-Ife, Osun State Nigeria. Data were collected by employing a structured and pretested open ended questionnaire. The data indicated that 21%, 17% and less than 5% of the respondents had used honey for wounds, respiratory tract infections and gastroenteritis respectively. Neither educational nor professional status had any significant influence on the usage of honey in the treatment and prevention of common illness (p > 0.05). The vast majority (55%) preferred refined sugar to honey. The study has some policy implications. The first is the need for an intensive nutrition education programme that will disseminate the health benefits of honey as a source of energy, essential nutrients and its antioxidant properties. The second is the need to promote its usage in clinical trials because of its antibacterial properties.

The influence of sociodemographic factors on awareness, knowledge and attitude toward andropause among health professionals in Ile-Ife, Nigeria.

A descriptive study of the awareness, knowledge and attitude of health professionals toward andropause was conducted in Ile-Ife, Nigeria with the aim of assessing the influence of sociodemographic variables of the respondents on their perspectives of the subject matter. The study employed a structured questionnaire to assess respondents' level of awareness and knowledge, and Likert-type scales to rate respondents' attitudes. A total of 187 (45%) respondents indicated previous awareness of andropause, with younger people (aged below 40 years) displaying better awareness compared with the older ones (p = 0.05), and more doctors than 'other technical health professionals' displaying better awareness when compared with health administrators (p < 0.001). However, only 93 (23%) respondents demonstrated a good knowledge of andropause, with more females compared with males recording good knowledge scores (p = 0.01). While a slightly higher proportion of older respondents (aged 40 years and above) compared with younger ones demonstrated good knowledge of andropause, age and marital status were not significantly related to knowledge of the subject matter. While only 23 (5.4%) respondents displayed a positive attitude toward andropause, and respondents' knowledge was found to positively influence their attitude toward it, none of the sociodemographic variables of age, sex or marital status was significantly related to respondents' attitudes. The study concluded that there is still a low level of awareness and knowledge of andropause among health workers in Nigeria, unlike what obtains in more developed countries of the world, and called for active education of both health professionals and the general public on the subject matter of andropause and other related male reproductive health concerns in the country.

Assessment of knowledge and practice of nutritional and life style risk factors associated with cancer among hospital workers at two university teaching hospitals in Osun State, Nigeria.

The objectives of this study were to assess both the predisposing and precipitating risk factors in the aetiology of any form of cancer among hospital workers at two teaching Hospitals in Osun State, Nigeria. Pre-tested and modified questionnaires were administered to 250 respondents. One hundred and seventy questionnaires were duly filled and completed. Less than 9% of the respondents consumed fruits and vegetables on a daily basis; while the highest percentage (65%) regularly consumed butter/margarine, followed with consumption of red meat. Twenty nine percent (29%) from both locations were classified as overweight and obese. Half did physical exercise twice a week. Of the 168 respondents. 34 (20.2%) did meet the criteria for completely emptying their bowels within a specified time of three minutes. It is concluded that whilst predisposing risk factors do not pose a threat to the onset of any form of cancer among respondents, precipitating factors are real major factors that need to be addressed through information, education and communication (I.E.C). Such an I.E.C. should be geared towards promotion of healthy eating and life style strategies. Alter all, 'the first step in cancer prevention is knowing the risk profile'.

Assessment of andropause awareness and erectile dysfunction among married men in Ile-Ife, Nigeria.

Andropause (also known as androgen decline in aging males) has implications for the reproductive health and quality of life of older males. Very few studies have, however, been reported among the Nigerian population on andropause-related issues. This study assesses the perspective and level of awareness of married men in Ile-Ife, South-west Nigeria, of andropause. We also assessed their experience of erectile dysfunction, using a questionnaire based on the review of the International Index of Erectile Dysfunction. The study involved 355 married men, aged between 30 and 70 years. Our result shows a high level of misconception about andropause among our respondents, with 38.9% indicating that it is a myth, and another 23.6% attributing it to various causes other than being a natural aging process. We recorded a prevalence of erectile dysfunction of 43.8% (8.0% severe dysfunction and 35.8% moderate dysfunction). The prevalence of erectile dysfunction increased significantly with age, varying from 38.5% for age 31-40 years to 63.9% for the older age group of 61-70 years. The trend in prevalence of erectile dysfunction with age was significant (p < 0.05). An odds ratio of 2.82 (95% confidence interval 1.19-6.76) was recorded for the prevalence of erectile dysfunction at age 61-70 years compared with age 31-40 years. Our findings indicate a need for health education about andropause in Nigeria, and increased attention to the reproductive health concerns of males, and the older population.

A study on under five nutritional status and its determinants in a semi-rural community of Ile-Ife, Osun State, Nigeria.

Ten variables were assessed as they influence the under five (U5) nutritional status of children at Oranfe, a semi-rural community in Ife East Local Government Area of Osun state, Nigeria. The two types of protein energy malnutrition (PEM) that are prevalent in the community are stunting and wasting. Of the 230 children assessed using Waterlow's technique, 23% and 22.6% were stunted and wasted respectively. The results confirmed that mothers' educational level, age, parity, types of family and children's immunization status and age are some of the key determinants of nutritional status of U5 children. The intensification of exclusive breast feeding, female education, a compulsory food demonstration unit in all health centres, use of complementary feeds from 7 months upwards, growth monitoring and promotion are some of the strategies to reduce the high prevalence of PEM in both rural and urban areas of developing countries.

Evaluation of an innovative approach to community-based medical undergraduate education in Nigeria.

CONTEXT: Although innovative, community-oriented and PHC-focused medical education programmes have been in operation in some medical schools in Nigeria for over a decade, they are yet to be comprehensively evaluated. OBJECTIVE: This study therefore aimed at evaluating some impacts of the programmes on medical education in the country. METHODS: The study was conducted in three innovative medical schools in South-Western Nigeria. Two traditional medical schools were selected as control. Questionnaires were used for the collection of data from random samples of 44 final year medical students in the innovative medical schools (SIMS) and 40 final year medical students in the traditional medical schools (STMS). Forty (40) medical graduates of the innovative medical schools (GIMS) and 33 graduates of the traditional medical schools (GTMS) also participated in the study. In addition, in-depth interviews of key stakeholders of the programmes and focus group discussions of selected members of the communities were conducted. FINDINGS: Findings revealed that the graduates of the innovative schools were better exposed to PHC education than those in the traditional schools. Their perceptions of the objectives of, and functions during, the PHC education were significantly different. Methods of learning during the programmes appear to be more experiential and inductive. Attitudes of members of rural communities were also favourable to the programmes. CONCLUSION: The innovative programmes appear to have impacted positively on medical education in the country. A major deficiency of the programmes is inadequacy of human and material resources for their effective functioning.

Sociocultural practices influencing under five nutritional status in an urban community in Osun State, Nigeria.

Three hundred and forty four preschool children from Ilare district of Ife Central Local Government Area of Osun State, Nigeria were assessed for nutritional status using selected and sensitive anthropometric techniques. The sociocultural practices of the parents were also examined. Approximately 53.8% and 54.7% of the children were identified to be malnourished and stunted respectively. The socioeconomic situation of the family was identified to have a significant influence on the child's nutritional status. Female children were observed not to be as adequately nourished as their male counterparts. However parity and food taboo had no significant influence on the child's nutritional status. The need for improvement in the socioeconomic status of the family and education of the community on the importance of female nutrition are discussed.

Modification and improvement of nutritive quality of cornpap "Ogi" with cowpea and groundnut milk.

The study aimed at improving the nutritive quality of cornpap, "Ogi", the most popular infant feed in Nigeria. Milk samples of cowpea, groundnut and soyabean and their complementations with cornpap were assessed chemically, organoleptically and anthropometrically. The protein contents of milk from cowpea, groundnut and soyabean were 1.18, 1.6, and 1.23% respectively. On separate complementation of the milk sources with cornpap, the low protein content of "ogi" was increased from 0.3% to 2.79% with cowpea; 3.0% with groundnut and 3.64% with soyabean. The fat content of the complementary feeds also increased remarkably. The anthropometric study revealed that there were significant differences P = 0.001 between the mean weight of children aged 13 to 18 (92 +/- 1.2) and 19 to 24 months (9.9 +/- 1.3) who were fed the three sources of milk with cornpap, and the control group of the same age groups (8.5 + 1.5; 9.3 + 1.11) who received nutrition education and no complementary feeds. Of the three sources of milk, groundnut milk was ranked as the most likeable, the easiest to prepare and the least costly by the nursing mothers. This study has shown that some of the deep rooted cultural food taboos that prohibit locally available and nutritious feeds to infants could be changed through practical food demonstrations.

Promotion of exclusive breastfeeding (EBF): the need to focus on the adolescents.

This study was designed to assess the knowledge and attitude towards exclusive breast feeding among 377 female students of School of Health Technology, Ilesha and to compare their responses with 60 primigravidae attending antenatal clinic in Ile-Ife, Nigeria. The ages of the subjects ranged from 15 to 34 years. Data were collected using pretested structured questionnaire. Approximately 47% of the total population were grouped under low level of knowledge of exclusive breastfeeding. There was no significant relationship in terms of knowledge between the two groups. There was, however, a significant relationship between the age of subjects and increased level of knowledge about EBF. Seventy percent of the primigravidae were graded as having poor attitudes as compared with 18% of the female students. About 42% of the total population would give water and glucose D water to neonates within 72 hours after delivery. These findings further suggest that planners of the Baby Friendly Initiative need to focus more on adolescents and the primigravidae in the promotion of breastfeeding.

Breast feeding practices in urban and rural health centres: impact of baby friendly hospital initiative in Ile-Ife, Nigeria.

The present study was carried out to assess the impact of the Baby Friendly Hospital Initiative (BFHI) on breast feeding practices. The variables used to evaluate the BFHI centre included time of initiation of breastfeeding (BF) after delivery, intended duration of BF, adoption of exclusive breastfeeding (EBF) in relation to educational status, location of health centre, and knowledge and practice of positioning the child at the breast. Observation, questionnaire and interview techniques were employed to collect the data among 217 and 214 nursing mothers (NMs) from Urban and Rural Health Centres. Of the 228 NMs who initiated BF within 30 minutes after delivery, 140 (61%) were from a designated BFHI Centre and 88 (39%) were from an undesignated BFHI rural health centre. There was a significant relationship between the practice of EBF and designation of BFHI centre (P = 0.0001). The higher the level of education of the NMs, the higher the present of NMs subscribing to EBF (P = 0.0001). The present study has also confirmed that EBF which was once considered to be less than 3%, has increased significantly to 61%. The success was not unconnected with the inauguration of BFHI. The BFHI is recording huge success in the urban area but the impact is still to be felt in the rural areas.

Anthropometric evaluation of cachexia in chronic congestive heart failure: the role of tricuspid regurgitation.

Cardiac cachexia has recently been identified as an independent risk factor for mortality in chronic congestive heart failure. The aims of our study were to further identify the clinical or biochemical predictors or correlates of the cachexia, and to quantitate the magnitude of wasting. We undertook an anthropometric comparison of 30 patients with congestive heart failure, aged 56 (13) years, with ten age- and sex-matched healthy volunteers and 16 patients with essential hypertension. In comparison to the healthy volunteers, the heart failure patients exhibited a trend towards a lower body mass index, 21 (2.7) versus 23 (3.8) kg/m2, the 95% confidence interval for the difference being -0.54 to 5.4. However, the mid-upper arm circumference, of 24 (3.8) cm in the heart failure patients, was significantly (P<0.02) lower than the 27 (2.0) cm in the healthy volunteer group, with a 95% confidence interval for the difference being 1.18 to 4.82 cm. The triceps, mid-thigh, scapula and abdominal skinfold thicknesses were separately and significantly (P<0.05) diminished in the heart failure patients compared to the healthy controls. The sum of the four skin fold thicknesses, with a value of 68 (13) mm in the healthy volunteers, was highly significantly greater (P<0.001) than the value of 35.6 (9) mm in the heart failure patients. The 95% confidence interval for this difference was 22.7 to 41.3 mm. The patients with essential hypertension differed significantly from the heart failure patients in all of these parameters (P<0.01), but were not statistically different from the healthy controls in the anthropometric parameters. Among the heart failure patients, those with tricuspid regurgitation (n = 12) had a worse clinical, biochemical and cachexia profile compared to patients without the tricuspid regurgitation (n = 18). The values (tricuspid regurgitation versus no regurgitation) were New York Heart Association Class, 3.5 (0.65) versus 2.7 (0.75), P<0.01; ejection fraction of 34 (9) versus 43 (13)%, not significant; greater hepatomegaly of 159 (31) versus 135 (29) mm, P<0.05; more severe hypoalbuminemia, 24.5 (2.7) versus 28.5 (6.8) g/l, P<0.05; and worse hyponatremia, 128 (4) versus 133 (5) mmol/l, P<0.05. The tricuspid regurgitation group had a significantly more severe reduction in abdominal and scapula skin fold thickness (P<0.01) than that found in patients without tricuspid regurgitation. The sum of the four skin fold thicknesses was significantly lower (P<0.05) in tricuspid regurgitation, 30.9 (8) mm, than in heart failure without associated regurgitation, 38.0 (9.6). The 95% confidence interval for the difference was 0.8 to 13.4 mm. It is concluded that significant diminution of muscle bulk and subcutaneous fat occurs in chronic heart failure. Tricuspid regurgitation may be an accentuating and accelerating risk factor for cardiac cachexia, on account of a greater hypoalbuminemia and hyponatremia, which, presumably, results from the associated protein-losing enteropathy.

Dietary and lifestyle patterns in the aetiology of cataracts in Nigerian patients.

The objective of the study was to assess the dietary and lifestyle habits of patients with cataracts. A food frequency questionnaire was used to collect information on the consumption of a wide variety of food items especially fruits, vegetables and animal and dairy products. A structured questionnaire was used to collect information on smoking and alcohol consumption habits. The study was conducted on 62 subjects made up of 31 patients with cataracts attending the Ophthalmology clinic of Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria and 31 control subjects without cataracts. There were 20 males and 11 females in each group. The study showed that higher percentages of controls than patients had adequate intakes of fruits and vegetables. Vitamin supplement usage was also higher in controls than patients. There was a strong negative association between past history of smoking, alcohol consumption and cataract. We could not demonstrate a relationship between body mass index (BMI) and cataract in the present study.

Infant feeding practices in a deprived environment: a concern for early introduction of water and glucose D water to neonates.

The main objective of this study was to inquire from lactating mothers whether they were fully or partially practising exclusive breastfeeding in the first six months postnatally. Time of initiation of breast and complementary feedings, types of feeds and reasons for giving other feeds to infants apart from breast milk were also examined. The data were collected by structured pretested questionnaire. Of the 200 nursing mothers interviewed, 103 (51.5%) and 77 (38.5%) reported to have given water and glucose D water to neonates respectively within the first week of life. Sieved cornpap was the popular weaning diet. Time of introducing complementary feeding to infants, and nursing mothers' educational levels, were highly significantly related (P = 0.005). Surprisingly, none of the nursing mothers listed infant formula as one of the complementary feeds. It is concluded that there is a strong need to correct this unnecessary practice of giving water and glucose D water to neonates to prevent thirst and Jaundice respectively. The correction should commence with health workers and then the nursing mothers.

PIP: This paper examines the practice of exclusive breast-feeding in the first 6 months after birth among lactating mothers in Ile-Ife, Osun State, Nigeria. The study also determines the time of initiation of breast-feeding and complementary feedings, type of feeds, and reasons for giving water and glucose D water to neonates. The investigation was carried out among 200 nursing mothers using pre-tested structured questionnaire. Of the 200 nursing mothers interviewed, 103 and 77 reported to have given water and glucose D water to neonate respectively within the first week of life. Mothers usually used sieved cornpap as a weaning diet. The time of introducing complementary feeding to infants were significantly related to the nursing mother's educational levels. Surprisingly, none of the nursing mothers listed infant formula as one of the complementary feeds. This study suggests that there exists a wrong practice in the timing of starting complementary feeding to neonates. The practice of giving water and glucose D water to neonates to prevent thirst and jaundice, respectively, is unnecessary. Therefore, necessary corrective measures are needed.