The role of mothers in household health-seeking behavior and decision-making in childhood febrile illness in Okurikang/Ikot Effiong Otop community, Cross River State, Nigeria.

The authors examine mothers and decision making during childhood febrile illness in rural Nigeria in this article. Employing a cross-sectional descriptive community survey, we elicited information from four categories of caregivers with the help of structured questionnaires. Apart from sociostructural economic factors, the authors reveal how interlocking objectives and values as expressed in extended family institutions functioned to influence both behavior and decision making of mothers. We suggest expanding the target of health education in the rural areas to include the family as an extended structure.

Awareness and acceptability of strategies for preventing mother to child transmission of HIV among antenatal clients in Calabar, Nigeria.

BACKGROUND: Mother to child transmission is the major route through which children below the age of 15 years acquire HIV infection. The most effective way to reduce childhood HIV infection is to prevent the infection in mothers and for already infected mothers use appropriate strategies to prevent transmission to their children. This study was conducted to determine the level of awareness and acceptability of strategies for preventing mother to child transmission of HIV. METHOD: Exploratory multi-centric descriptive study involving 400 antenatal attendees in Federal, State and a Private health facility was used. Interviewer-administered questionnaire was the tool for data collection. RESULT: Majority of the respondents (94.7%) were aware of transmission of HIV from an infected mother to her child. Respondents were more aware of the use of antiretroviral drugs in pregnancy (63.2%) than they were of avoiding breastfeeding (58.5%) and Cesarean delivery (22.8%) as strategies for preventing mother to child transmission. They were also more likely to accept the use of antiretroviral drugs (78.2%) than they would avoid breastfeeding (69.0%) and accept Cesarean delivery (38.0%) for preventing mother to child transmission of HIV High educational status was significantly associated with a positive attitude to these strategies. CONCLUSION: There is need for more educational programs and social support to bridge the gap between the levels of awareness and acceptability of strategies for preventing mother to child transmission of HIV among the populace.

Patients' perception of obstetric practice in Calabar, Nigeria.

OBJECTIVE: To determine the influence of patients' perception of obstetric practice in Calabar on the low utilization of health facilities for delivery. METHODS: The University of Calabar Teaching Hospital, the general hospital and eight private clinics in Calabar were visited daily for a period of one month to interview postnatal mothers. This was to ascertain the mothers' perception of obstetric care in these facilities and their attitude towards some selected birth practices. RESULTS: All the interviewed mothers had some formal education, and 133 (92.4%) were aged 20 years and above. One hundred and forty (97.2%) of the mothers were satisfied with at least one aspect of care received. Areas of satisfaction mentioned by the mothers include attitude of health staff 114 (81.4%), clinical care received 85 (60.7%), sanitation of the facility 61 (43.6%), and basic amenities 47 (33.6%), poor sanitary condition of the health facility and lack of basic amenities were the major causes of dissatisfaction. Few mothers, 31 (22%) disagreed with dorsal position during second stage of labor. Most mothers, 92 (63.9%) would want pain relief in labor; 19 (13.2%) did not appreciate shaving of pubic hair and 50 (34.7%) felt episiotomy was not necessary for safe delivery. CONCLUSION: To improve the utilization of obstetric services in Calabar, basic amenities such as water and sanitation should be provided; and there should be restriction of routine birth practices that have no evidence of effectiveness.

Factors associated with missed opportunities to immunise with tetanus toxoid at a tertiary health institution in Nigeria.

OBJECTIVE: To determine the magnitude of and the reasons for missed opportunities to immunise with tetanus toxoid at a tertiary health institution in Nigeria. The information obtained would be used in developing an intervention strategy for eliminating missed opportunities in the future. DESIGN: Missed opportunity was assessed by using the Revised WHO/EPI protocol (WHO/EPI/MLM/91.7). Exit interviews were carried out on pregnant women visiting the antenatal (prenatal) clinic to register the present pregnancy. SETTING: A tertiary health institution in Nigeria. SUBJECTS: Pregnant women who attended the antenatal clinic for the purpose of registering the present pregnancy during the last two booking days in February, 1997 and the first booking day in March, 1997. MAIN OUTCOME MEASURES: Missed opportunities and contributory factors. RESULTS: The prevalence of missed opportunity was 66%. The factors responsible for missed opportunity were poor history taking, lack of knowledge of the current schedule of immunisation, dependence on physician referral for immunisation and inefficient immunisation record keeping system. CONCLUSION: The findings establish the need for providing physicians in antenatal settings with an update on current immunisation policy and practice and for improved documentation of immunisation histories.

PIP: This report presents the magnitude of the problem and the reason for missed opportunities for tetanus toxoid (TT) immunization at the University of Calabar Teaching Hospital (UCTH) in Nigeria. The information obtained will be used in developing a strategy for eliminating missed opportunities in the future. The subjects were all pregnant women who attended the antenatal clinic for the purpose of registering pregnancy during the last two booking days in February 1997 and the first booking day in March 1997. Information were collected from 54 pregnant women by means of exit interview conducted by trained by data collectors. Information obtained includes: dose(s) of TT received and when; record of offer of TT; and acceptance or decline of TT offered. Results of the exit interview showed a 66% prevalence rate of missed opportunity. Factors contributing to this high prevalence of missed opportunity were poor history taking, lack of knowledge of current schedule of immunization, dependence on physician referral for immunization, and an inefficient immunization record keeping system. The findings point out the need to provide physicians in antenatal settings with an update on current immunization policy and practice and for improved documentation of immunization histories.

Social determinants of alcohol use among drivers in Calabar.

OBJECTIVE: Hazardous use of alcohol is a public health problem which accounts for 4.0% of global disease burden. Although the prevalence of alcohol use among drivers of commercial vehicles in Nigeria has been documented, not much is known about its social determinants. This study was, therefore, aimed at assessing the social determinants of alcohol use among drivers of commercial vehicles in Calabar. MATERIALS AND METHODS: A cross-sectional descriptive study was conducted among 360 male commercial drivers. A semistructured questionnaire, which included the World Health Organization Alcohol Use Disorders Identification Test, was administered at interview. Binary and multinomial logistic regression analyses were used to identify social determinants of any and hazardous alcohol use. RESULTS: Determinants of any alcohol use (binary logistic) were history of use by parents (adjusted odds ratios (AOR)=2.7; 95% CI=1.1-6.3), friends (AOR=3.2; 95% CI=1.3-7.8) and ready availability (AOR=4.1; 95% CI=1.9-8.8) while determinants of hazardous use (multinomial logistic) were history of use by parents (AOR=5.8; 95% CI=2.0-16.9), siblings (AOR=7.0; 95% CI=2.6-16.9), friends (AOR=6.6; 95% CI=1.8-24.4), hostile upbringing environment (AOR=3.8; 95% CI=1.3-11.1), use of other drugs (AOR=55.6, 95% CI=14.5-200), and respondents who had fathers with a maximum of primary or no formal education (AOR=4.6; 95% CI=1.8-11.8). CONCLUSION: Alcohol use was associated with family use, friends' use, and use of other drugs. Multiple health education interventions are needed to tackle these challenges.

Exposure of petrol station attendants and auto mechanics to premium motor sprit fumes in Calabar, Nigeria.

A population-based-cross-sectional survey was carried out to investigate the potential risk of exposure to premium motor spirit (PMS) fumes in Calabar, Nigeria, among Automobile Mechanics (AM), Petrol Station Attendants (PSA) and the general population. Structured questionnaire was administered on the randomly chosen subjects to elicit information on their exposure to PMS. Duration of exposure was taken as the length of work in their various occupations. Venous blood was taken for methaemoglobin (MetHb) and packed cells volume (PCV). Mean MetHb value was higher in AM (7.3%) and PSA (5.8%) than in the subjects from the general population (2.7%). PCV was lower in PSA (30.8%), than AM (33.3%) and the subjects from the general population (40.8%). MetHb level was directly proportional, and PCV inversely related, to the duration of exposure. The study suggested increased exposure to petrol fumes among AM, PSA, and MetHb as a useful biomarker in determining the level of exposure to benzene in petrol vapour.