Knowledge and Utilization of PMTCT Services among Women accessing Antenatal Care in Private Health Facilities in Abakaliki, Nigeria.

Prevention of mother-to-child transmission (PMTCT) of HIV programme provides antiretroviral treatment to HIV-positive pregnant women to reduce the likelihood of transmission to their infants. Despite concerted efforts to scale-up PMTCT services in Nigeria, coverage and uptake of the services by Antenatal Care (ANC) attendees is below the acceptable. Private health facilities provide ANC services to large number of women, but they are sparingly involved in PMTCT capacity enhancement interventions. This study assessed the knowledge and utilization of PMTCT services among women accessing antenatal care in Private Health facilities in Abakaliki, Ebonyi State. It was a descriptive cross-sectional study in ANC clinics of the health facilities. Data was collected using interviewer administered questionnaire and analysed with Statistical Package for Social Sciences (SPSS) version 22.0 and test of association was by Chi square at P<0.05 level of significance. Results showed mean age of the respondents was 27± 4.6 years. Majority of the respondents (83.4%) had good knowledge of PMTCT but only 68.4% accessed HIV Counselling and Testing (HCT) in the index pregnancy, with fear of stigmatization given as the major reason for not doing HCT. Only 54.5% of sero-positive attendees took anti-retroviral drugs (ARVs) during pregnancy though they all used ARVs during labour/ delivery. Utilization of PMTCT services of HIV wassignificantly associated with educational status and occupation. CONCLUSION: There was good knowledge of PMTCT but utilization of the services was suboptimal. Training and mentoring of health care workers in private facilities on HIV testing programmes is important to improve uptake of PMTCT services and allay fears of stigmatization among the pregnant women.

Le programme de prévention de la transmission mère-enfant (PTME) du VIH fournit un traitement antirétroviral aux femmes enceintes séropositives pour réduire la probabilité de transmission à leurs nourrissons. Malgré les efforts concertés pour étendre les services de PTME au Nigeria, la couverture et l'utilisation des services par les personnes participant aux soins prénatals (ANC) sont inférieures à l'acceptable. Les établissements de santé privés fournissent des services de soins prénatals à un grand nombre de femmes, mais ils sont peu impliqués dans les interventions de renforcement des capacités de PTME. Cette étude a évalué la connaissance et l'utilisation des services de PTME chez les femmes ayant accès aux soins prénatals dans les établissements de santé privés à Abakaliki, dans l'État d'Ebonyi. Il s'agissait d'une étude transversale descriptive dans les cliniques de soins prénatals des établissements de santé. Les données ont été recueillies à l'aide d'un questionnaire administré par l'intervieweur et analysées avec le logiciel Statistical Package for Social Sciences (SPSS) version 22.0 et le test d'association a été effectué par le Chi carré au niveau de signification P<0,05. Les résultats ont montré que l'âge moyen des répondants était de 27 ± 4,6 ans. La majorité des personnes interrogées (83,4%) avaient une bonne connaissance de la PTME, mais seulement 68,4% ont eu accès au HCT lors de la grossesse de référence, la peur de la stigmatisation étant citée comme la principale raison de ne pas pratiquer le HCT. Seulement 54,5% des participantes séropositives ont pris des médicaments antirétroviraux (ARV) pendant la grossesse, bien qu'elles aient toutes utilisé des ARV pendant le travail/l'accouchement. L'utilisation des services de PTME du VIH était significativement associée au niveau d'instruction et à la profession. CONCLUSION: Il y avait une bonne connaissance de la PTME mais l'utilisation des services était sous-optimale. La formation et l'encadrement des agents de santé dans les établissements privés sur les programmes de dépistage du VIH sont importants pour améliorer l'utilisation des services de PTME et dissiper les craintes de stigmatisation parmi les femmes enceintes. Mots clés: Médicaments antirétroviraux, séropositifs, transmission mère-enfant, femmes enceintes, hôpitaux privés.

Appraisal of willingness to vaccinate daughters with human papilloma virus vaccine and cervical cancer screening uptake among mothers of adolescent students in Abakaliki, Nigeria.

BACKGROUND: By the end of 2017, human papillomavirus (HPV) vaccine had been introduced in 80 countries, but Nigeria proposes introducing the vaccine into her routine immunization program from late 2020 or early 2021. The current mode of HPV access in the country is through out-of-pocket purchase with only 1.4% of adolescent girls being vaccinated. Cervical cancer has remained the second highest cancer among women in Nigeria, and the incidence rate is significantly higher than the global rate. This study assessed the factors associated with HPV awareness and willingness to vaccinate daughters among mothers of female secondary school students in Abakaliki. MATERIALS AND METHODS: A cross-sectional study was carried out among 290 mothers of female students selected through multistage sampling technique using a pretested self-administered questionnaire. Data were analyzed with Epi Info™ version 7. RESULTS: The mean age of the mothers was 42 ± 8 years, and 72.8% attained at least secondary education, while 37.2% were traders. Their awareness of HPV and uptake of cervical cancer screening were low, 42.8% and 9%, respectively. Although 89.1% were willing to vaccinate their daughters, only 6.9% of their daughters had ever received HPV vaccine. Lack of awareness on HPV vaccine and cost of purchase were the most cited reasons for low vaccine uptake. Education, screening status, mother-daughter vaccination status, and willingness to encourage others on HPV vaccine for daughters were significantly associated with HPV awareness. CONCLUSION: Most of the mothers were willing to vaccinate their daughters with HPV vaccine, but they lack awareness and the financial resources for the access. There is an urgent need for vigorous enlightenment campaigns on HPV vaccine and cervical cancer screening. Adding HPV vaccine in the routine immunization program will improve universal access and address financial concerns.

Non-traumatic childhood coma in Ebonyi State University Teaching Hospital, Abakaliki, South Eastern Nigeria.

BACKGROUND: Coma is a medical emergency, and optimal management, especially in a resource-poor setting, would depend on the knowledge of its etiology and predictors of outcome. This communication reviews the etiology and outcome of non-traumatic childhood coma in Ebonyi State University Teaching Hospital (EBSUTH), Abakaliki. OBJECTIVE: To determine the incidence, etiology and outcome of non-traumatic coma in children seen at the EBSUTH, Abakaliki. MATERIALS AND METHODS: This is a retrospective analysis of records of all children admitted to the children emergency ward of EBSUTH in coma of a non-traumatic origin between 1 st of January and 31 st of December, 2007. RESULTS: Forty children presented with coma out of 673 children admitted during the study period, giving an incidence rate of 5.9%. The majority of the children (62.5%) were aged between 1 and 5 years of age, and 79.5% of them were deeply comatose on admission. Most of the cases (85%) of non-traumatic coma were due to infective causes, mainly cerebral malaria (47.5%), pyogenic meningitis (17.5%) and septicemia (10%). Twenty-four (60%) children recovered while 13 (32.5%) died. CONCLUSION: Infections were the predominant causes of non-traumatic coma in EBSUTH. In view of the high mortality among this group of patients, efforts at the control of malaria and other infections would significantly reduce the incidence of non-traumatic coma in this study site.

Non-Traumatic Childhood Coma in Ebonyi State University Teaching Hospital; Abakaliki; South Eastern Nigeria

Background: Coma is a medical emergency; and optimal management; especially in a resource-poor setting; would depend on the knowledge of its etiology and predictors of outcome. This communication reviews the etiology and outcome of non-traumatic childhood coma in Ebonyi State University Teaching Hospital (EBSUTH); Abakaliki. Objective: To determine the incidence; etiology and outcome of non-traumatic coma in children seen at the EBSUTH; Abakaliki. Materials and Methods: This is a retrospective analysis of records of all children admitted to the children emergency ward of EBSUTH in coma of a non-traumatic origin between 1 st of January and 31 st of December; 2007. Results: Forty children presented with coma out of 673 children admitted during the study period; giving an incidence rate of 5.9. The majority of the children (62.5) were aged between 1 and 5 years of age; and 79.5of them were deeply comatose on admission. Most of the cases (85) of non-traumatic coma were due to infective causes; mainly cerebral malaria (47.5); pyogenic meningitis (17.5) and septicemia (10). Twenty-four (60) children recovered while 13 (32.5) died. Conclusion : Infections were the predominant causes of non-traumatic coma in EBSUTH. In view of the high mortality among this group of patients; efforts at the control of malaria and other infections would significantly reduce the incidence of non-traumatic coma in this study site

Idiopathic central precocious puberty in a Nigerian boy.

A case of idiopathic central precocious puberty, a rare condition is reported in a 2 1/2 year-old Nigerian boy. He presented with progressive genital growth, a growth spurt, advanced skeletal maturation, and inappropriately high serum concentrations of pituitary and gonadal sex homones for his age. There was no family history of precocious puberty. Physical examination and investigations revealed no identifiable cause for his precocity. Despite the overwhelming problems of malnutrition and infectious diseases in our environment, clinicians must have a high index of suspicion for endocrine disorders.