Evaluation of a school-based health education program on hepatitis B virus infection prevention practice in rural South-Western, Nigeria.

BACKGROUND: Hepatitis B virus (HBV) infection prevention is most effective early in childhood with vaccination programme. However, where this is missed, primary prevention modes of intervention become an alternative recommendation to be considered before the occurrence of risk exposure to the virus. This study sought to evaluate outcomes of a theory-based HBV infection prevention educational intervention among students from four selected secondary schools in Ogun state, Nigeria. METHODOLOGY: A quasi-experimental design enrolling 256 consenting secondary school students from four schools in Ogun state randomized into three intervention schools consisting teacher-instructed (E1), peer-directed (E2) and combination of the two (E3) respectively with a control group ( C) was implemented. The theory-based educational intervention was for six weeks with follow-up period of 8 weeks. A 66-item validated instrument was used to collect data at three reference points and response items for variables in the study were transformed into weighted-aggregate scores of mean and standard deviation of HBV infection prevention practice of participants. Statistical analysis of ANOVA, paired-sample t-test and Cohen's D Effect Size (ES) was used to quantify the changes produced by the intervention on the outcome variable at 5% level of significance. RESULTS: At baseline, there was no significant difference (p > 0.05) in the mean HBV infection prevention practice scores between the four groups E1 (17.21 ± 3.03), E2 (15.57 ± 1.90), E3 (17.90 ± 3.10), and C (15.20 ± 2.44). However, at 14th week follow up, there was observed significant differences in mean scores of HBV infection prevention practices between all four groups E1 (23.09 ± 2.4), E2 (22.6 ± 3.6), E3 (23.82 ± 2.3), and C (15.25 ± 2.4). Paired-sample t-test conducted demonstrated significant differences between baseline and 14th week follow up for E1 (17.21 ± 3.07 and 23.18 ± 2.9; p = 0.001), E2(15.57 ± 1.90 and 23.53 ± 3.12; p = 0.001), E3(17.90 ± 3.10 and 25.1 ± 2.6; p < 0.001), but not for C (15.20 ± 2.44 and 15.25 ± 2.4; p = 0.92), with most significant impact (ES(95%CI) on HBV infection prevention practices observed for E2(3.106 95%CI: [2.66 to 3.55; p = 0.001]). Importantly, the participants in E2 showed more improvement in prevention practices than their counterparts from E1, E3, and control. Therefore, the intervention demonstrated proof-of-concept in facilitating behavior modification expected. Peer education can be utilized as a strategy to promote Hepatitis B infection prevention practices among adolescents.

Prevalence and personal predictors of risky sexual behaviour among in-school adolescents in the Ikenne Local Government Area, Ogun State, Nigeria.

Risky sexual behaviour increases the vulnerability of an adolescents to reproductive health problems like sexually transmitted infections (STIs), unintended pregnancy and abortion. This study therefore investigated the prevalence and personal predictors of risky sexual behaviour among in-school adolescents in the Ikenne Local Government Area, of Ogun State, Nigeria. The study employed a descriptive cross-sectional design. A multi-stage sampling technique was used to select 716 participants for the study. A validated semi-structured questionnaire with a Cronbach's alpha score of 0.78 was used to collect data. Frequency and logistic regression analysis were conducted to give statistical responses to the research question and hypotheses using SPSS version 23. The mean age of the participants was 15.2 ± 1.4 years and 57.3% of the respondents were female. Above a quarter (35.5%) of the respondents were in senior secondary one (SS1) in high school. More than half (53.1%) of the respondents had a good level of knowledge about risky sexual behaviour and 54% of the respondents had a fair perception of it. The respondents' attitudes towards risky sexual behaviour was moderately high (61.2%). The respondents had moderately high (63.7%) self-esteem. The prevalence of risky sexual behaviour was 19.2%. The personal predictors of risky sexual behaviour are age [odds ratio (OR) = 3.21; p < 0.05); gender [OR = 1.86; confidence interval (CI): 1.26-2.69; p < 0.05]; perception (OR = 2.58; CI: 1.55-4.30; p < 0.05); attitude (OR = 4.58; CI: 1.61-13.05; p < 0.05); self-esteem (OR = 7.39; p < 0.05). In conclusion, the respondents' risky sexual behaviours are predicted by age, gender, attitude, perception and self-esteem. The study therefore recommends that educational materials about the negative effects of the risky sexual behaviours should be included in the curriculum of secondary schools.

Knowledge, Perception and Management of Pre-eclampsia among Health Care Providers in a Maternity Hospital.

BACKGROUND: Morbidity and mortality of women and children associated with pre-eclampsia present major global health problems in low and middle income countries. The prevalence of pre-eclampsia in Nigeria ranges from 2% to 16.7%, with approximately 37,000 women dying from preeclampsia annually. This study examines knowledge, perception and management of preeclampsia among healthcare providers in a major maternity hospital in Lagos, southwest Nigeria. METHODS: In this descriptive cross-sectional study, 110 health care providers comprising of 75 Nurses, 9 Consultant Physicians, and 26 General Medical Practitioners with varying years of service were selected using purposive sampling technique. Data were collected using a self-administered 36-item semi-structured questionnaire. Data were analysed using the Statistical Package for Social Sciences to generate descriptive and inferential statistics with level of significance set at 0.05. RESULTS: Health care providers in the study had an average knowledge of pre-eclampsia with a mean score of 16.69±3.53. There was generally a good perception of pre-eclampsia with a mean sore of 28.31±3.71. The most-prevalent clinical management practices were emergency cesarean section (16%), magnesium sulphate infusion (29%), and fluid/electrolyte management (9%). Knowledge of pre-eclampsia and years of practice were significantly associated (F=3.31; p= 0.023). CONCLUSION AND GLOBAL HEALTH IMPLICATIONS: Gaps in the knowledge of causes, diagnoses, and treatment of pre-eclampsia may be attributable to lack of refresher trainings and absence of written practice guidelines on pre-eclampsia management. Health care providers at this hospital may benefit from training courses that include current nationally and internationally-approved management of pre-eclampsia.