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ASSESSMENTS OF THE MATERNAL CARE KNOWLEDGE AND PRACTICES OF TRADITIONAL BIRTH ATTENDANTS IN IBADAN, OYO STATE, NIGERIA
(2012-08) OLUKOTUN, E. A.
Traditional Birth Attendants (TBAs) are lay persons who attend to deliveries and concerted efforts have been made to train them. Anecdotal reports suggest that many expectant mothers patronize TBAs in Ibadan. However, there is dearth of information relating to the TBAs’ maternal care knowledge and practices. This study was therefore conducted to assess TBAs’ knowledge and practices relating to maternal care in Ibadan, Oyo State. A cross-sectional survey of 407 out of 608 TBAs who consented to be involved in the survey, in the 11 Local Government Areas (LGAs) in Ibadan was conducted. The three categories of TBAs were; 93 local government trained-TBAs, 221 church-based TBAs and 93 TBAs who practice in herbal homes. A semi-structured questionnaire was used to obtain information on respondents’ demographic characteristics, knowledge and practices of maternal care. Knowledge and practice scores were computed with the maximum obtainable scores being 43 and 47 respectively. Data were analyzed using descriptive statistics, Independent t- test, correlation and Chi-square statistics. Respondents’ mean age was 47.0±10.8 years, 86.0% had at least primary education and majority (84.8%) were females. Seventy-eight percent had formal TBA training; of these 63.0% reported that they were regularly supervised by skilled health workers. None of the untrained TBAs had regular supervision. Overall mean knowledge score was 79.7±20.3%. Majority (80.6%) of TBAs recognized blood pressure measurement as an essential aspect of Antenatal Care (ANC). Majority were aware of the necessity of wearing sterile gloves in taking delivery (83.0%) and prompt referral of high risk cases (76.7%). Trained TBAs had a significantly higher maternal care knowledge score compared with the untrained TBAs (p<0.05). Blood pressure measurement during ANC visits, wearing of sterile gloves, and referral of high risk cases were reported by 66.0%, 44.0% and 51.8% respectively. Trained TBAs had a significantly higher mean practice score compared to the untrained TBAs (p<0.05). A significantly higher proportion of the regularly supervised trained TBAs reported referring of high risk cases (83.8%) compared with unsupervised trained TBAs (53%) (p< 0.05). There was a poor correlation between the maternal care knowledge and practice of the trained TBAs (r=0.435, p<0.05). The practices of untrained and unsupervised traditional birth attendants fell short of professional expectation and knowledge-practice gaps were identified among all categories of traditional birth attendants. Training and regular retraining of traditional birth attendants as well as supportive supervision by health staff of the State Ministry of Health, Local Government Area Primary Health Care departments and relevant non-governmental organizations are needed to enhance maternal care practices of traditional birth attendants in Ibadan.
PREVALENCE AND TYPES OF FALL-RELATED INJURIES AMONG UNDER FIVE CHILDREN IN IBADAN NORTH LOCAL GOVERNMENT AREA, NIGERIA NIGERIA
(2012-11) LADAPO, O. J.
Globally, falls and ensuing injuries are significant causes of morbidity and mortality among under-five children. However, the associated burden and types of falls and fall-related injuries have not been adequately researched in Nigeria. This study was conducted to assess Primary Caregivers’ (PCs) level of knowledge, prevalence and types of fall-related injuries among under-five children in Ibadan North Local Government Area (IbNLGA). In this cross-sectional study, a three-stage random sampling technique was used to select 507 PCs of under-five children from five of the 12 wards within IbNLGA. A validated questionnaire which included a 30-point knowledge scale (causes of falls among under five children -9 points, prevention of falls -18 points and outcome of falls -3 points) was used for data collection from selected caregivers. Information was also obtained on the occurrence and outcome of falls sustained by each caregivers’ youngest under-five child (index child). Respondent’s scores were categorized as good (21-30 points), average (11-20 points) and poor (0-10 points). Data were analyzed using descriptive statistics and Chi-square. The PCs consisted predominantly of biological mothers (91.0%). Their mean age was 32.3±8.1 years and a larger proportion of them (43.8%) were secondary school certificate holders. Respondents’ median number of children was one (range 1 – 3) and 54% of the children were males. Of the children, 47% sustained at least a fall in a rented apartment (65.9) with majority having chair fall (25.8). Of this, 56.4% sustained injuries that required first aid interventions and 51.7% were admitted in a hospital for a median period of three days (range 1 – 9). Injuries sustained included bruises and minor swellings (63.2%), abrasions (33.8%) and fractures/dislocation (1.5%). Most of the PCs (85.6%) had good knowledge of falls and their mean knowledge score was 23.9±3.1. All the respondents mentioned at least one strategy for preventing falls. Strategies adopted included close supervision (82.8%), cautioning (59.2%), good housekeeping practices (7.7%) and environmental modifications (3.2%). More children of PCs aged ≤20 years (61.0%) were found to have sustained a fall compared with those aged ≥41 years (15.4%), (p < 0.05). A higher proportion of children of PCs who were Yoruba (51.9%) sustained a fall than the PCs who were Hausa (40.6%) and Igbo (35.5%) (p < 0.05). A higher proportion of children aged 12-24 months (61.2%) experienced falls compared with those aged <12months (39.7%), 37-48 months (34.5%) and 49-59months (33.0%) (p<0.05). Prevalence of fall-related injuries among the under-five children poses a serious challenge of public health importance. This is because under-five is a period to determine their potential to learn and thrive for a life time, their physical and intellectual development might be impaired. Knowledge of prevention of falls was high but only a few were aware of appropriate preventive measures. Interventions to increase knowledge of primary caregivers are therefore recommended.
HEALTH RELATED QUALITY OF LIFE OF STUDENTS WITH PHYSICAL AND SENSORY IMPAIRMENTS IN SPECIAL AND INTEGRATED SCHOOLS IN IBADAN.
(2012-11) TOMORI, O.
The determination of Health-Related Quality of Life (HR-QoL) is useful for assessing the impact of health and illness on people’s physical, psychological and social functioning. In Nigeria, the HR-QoL of students (who are mostly adolescents) with physical and sensory impairments has not been adequately researched. There is need for scientific basis for comparative description of the experiences of Students with physical and sensory impairments (SwPSI) in special schools (SS) and integrated schools (IS). Further, the self-perceived needs of these students are yet to be assessed as well as factors influencing their HR-QoL An interviewer-administered questionnaire adapted from the World Health Organization International Classification of Functioning, Disease and Health and Short-Form Health Survey-36, was used to obtain information from all 330 eligible students in 7 IS and 8 SS in Ibadan. Students less than 10 years old and those who had mental disabilities in combination with physical disabilities were excluded. Cluster sampling method was used. Respondents’ HR-QoL was assessed using 84-point scale. Scores of < 41and > 42 points were taken as low and high HR-QoL respectively. Domains of HR-QoL assessed with points include interpersonal relationship-11, general participation-15, performance in physical activities-19, general health-12, vitality-12 and mental health-15. Data were analyzed using descriptive statistics and t test. Participants’ mean age was 15+3.9 years and 57.6% were males. Respondents from SS and IS constituted 59.7% and 40.3% respectively. The respondents included those with hearing and speech impairments (32.1%), hearing impairments only (24.2%), multiple physical deformities= (12.4%), speech impairments only (7.0%), visual impairments only (4.5%), limb impairments (13.6%), hearing impairments with other physical deformities (2.7%), speech impairments with other physical deformities (2.7%) and other types of physical deformities (0.6%). The mean HR- QoL scores of respondents in SS and IS were 48.3+10.6 and 50.1+10.0 respectively (p>0.05). The respective domain HR-QoL scores of students in IS and SS were: interpersonal relationship-(IS-7.5, SS-7.1) general participation-(IS-9.0, SS-7.7) performance in physical activities-(IS-12.1, SS-12.0) general health-(IS-7.4, SS-7.3) vitality-(IS-6.3, SS-6.1) and mental health-(IS-7.7, SS-8.2). Students in IS had higher scores in all domains except mental health. Students with visual impairment had the highest (52.1) HR-QoL score while those with multiple physical impairments had the least (39.5; p<0.05). Students in IS with visual impairment had highest scores in general health (9.9) and interpersonal relationship (8.8) while students in SS with hearing impairments had highest scores in general participation (8.3), vitality (7.1), general health (8.2) and mental health (9.2; p<0.05). The various needs identified by students in IS included more of Physiological needs and self-actualization needs while those in SS identified more of need for love and belonging and self-esteem needs. Factors identified in this study to be significantly associated with HR-QoL of SwPSI include family environment, school environment, type of impairment, use of individual education plan (IEP) and parental socio-economic status. Students kept in special schools had lower quality of life. It is therefore more beneficial to enroll students with limb, visual and speech impairments in integrated schools in order to improve their HR-QoL.
FACTORS INFLUENCING PARENTAL DECISIONS ON ADOLESCENT PREGNANCY AMONG RURAL AND URBAN-BASED PARENTS OR GUARDIANS IN IBADAN, NIGERIA
(2013-02) MATTHEW, O. O.
Adolescent pregnancy is an important public health problem on the increase in Nigeria. Few studies have investigated the circumstances and factors associated with parental decisions taken following an adolescent pregnancy, in spite of the implications of these on the adolescent. This study was designed to assess factors influencing parents’/guardians’ decisions on adolescent pregnancy. A mixed method study involving the use of Key Informant Interviews (KII) and semi-structured interview was conducted. A four-stage sampling technique was used to select 261 and 244 respondents from Omi-Adio (rural) and Apata (urban) communities respectively. KII were conducted with twelve parents; (six each from urban and rural settings) who has had personal experiences of a pregnant adolescent. Descriptive and Chi-square statistics, and logistic regression were used for data analysis and qualitative data was analyzed using thematic analysis. The UK Registrar general’s classification of occupation and socioeconomic status was used. Mean age of respondents from rural and urban communities were 50+9.4 years and 48+10.1 years respectively. Fifty-five percent of urban and 30.1% of rural respondents had tertiary education. More rural (70.3%) than urban respondents (35.4%) were in the low socioeconomic group. More rural (91.9%) than urban dwellers (88.9%) supported keeping an adolescent pregnancy. More urban (93.4%) than rural (76.3%) dwellers were of the view that an adolescent should continue school after delivery (p<0.05) while 25% of rural respondents and 18.0% of urban respondents mentioned that a pregnant adolescent be married to the person responsible for the pregnancy (p<0.05). Personal experience of adolescent pregnancy occurred in 17.2% and 16.4% of rural and urban respondents respectively. Adolescent pregnancy occurred in children and relations of respondents. Among rural respondents, the pregnant adolescents were either the respondents’ younger sibling (51.1%) or child (48.9%). In the urban area the pregnant adolescents were the respondents’ younger sibling (75.0%), child (20.0%) or the respondent/ his spouse (5%). More urban (85%) than rural respondents (60%) decided to keep the pregnancy (p<0.05). The decision to keep the pregnancy was mainly attributed to religious beliefs among the rural respondents (68%) and health reasons among their urban counterparts (76.5%). Urban dwellers were 5 times more likely to decide to keep the pregnancy than rural respondents (OR = 5.48, 95%CI = 1.71 - 17.59). Respondents in the high socio-economic group were less likely to decide to keep the pregnancy (OR = 0.20, 95% CI=0.06-0.65). The initial reactions of the key informant interviewees to discovery of pregnancy were disappointment. In the urban area, very few pregnant adolescents were said to have continued schooling till delivery and many of them resumed school thereafter while in the rural area, they all dropped out of school. Place of residence, socio-economic status and religion were key factors influencing decision to keep adolescent pregnancy with urban dwellers more favourably disposed than rural dwellers. Intervention programmes thus need to target those in rural areas to change their views regarding keeping of adolescent pregnancies and encouraging re-integration of adolescents that get pregnant.
FACTORS INFLUENCING PARENTAL DECISIONS ON ADOLESCENT PREGNANCY AMONG RURAL AND URBAN-BASED PARENTS OR GUARDIANS IN IBADAN, NIGERIA
(2013-02) OLAYEMI, O. M.
Adolescent pregnancy is an important public health problem on the increase in Nigeria. Few studies have investigated the circumstances and factors associated with parental decisions taken following an adolescent pregnancy, in spite of the implications of these on the adolescent. This study was designed to assess factors influencing parents’/guardians’ decisions on adolescent pregnancy. A mixed method study involving the use of Key Informant Interviews (KII) and semi-structured interview was conducted. A four-stage sampling technique was used to select 261 and 244 respondents from Omi-Adio (rural) and Apata (urban) communities respectively. KII were conducted with twelve parents; (six each from urban and rural settings) who has had personal experiences of a pregnant adolescent. Descriptive and Chi-square statistics, and logistic regression were used for data analysis and qualitative data was analyzed using thematic analysis. The UK Registrar general’s classification of occupation and socioeconomic status was used. Mean age of respondents from rural and urban communities were 50+9.4 years and 48+10.1 years respectively. Fifty-five percent of urban and 30.1% of rural respondents had tertiary education. More rural (70.3%) than urban respondents (35.4%) were in the low socioeconomic group. More rural (91.9%) than urban dwellers (88.9%) supported keeping an adolescent pregnancy. More urban (93.4%) than rural (76.3%) dwellers were of the view that an adolescent should continue school after delivery (p<0.05) while 25% of rural respondents and 18.0% of urban respondents mentioned that a pregnant adolescent be married to the person responsible for the pregnancy (p<0.05). Personal experience of adolescent pregnancy occurred in 17.2% and 16.4% of rural and urban respondents respectively. Adolescent pregnancy occurred in children and relations of respondents. Among rural respondents, the pregnant adolescents were either the respondents’ younger sibling (51.1%) or child (48.9%). In the urban area the pregnant adolescents were the respondents’ younger sibling (75.0%), child (20.0%) or the respondent/ his spouse (5%). More urban (85%) than rural respondents (60%) decided to keep the pregnancy (p<0.05). The decision to keep the pregnancy was mainly attributed to religious beliefs among the rural respondents (68%) and health reasons among their urban counterparts (76.5%). Urban dwellers were 5 times more likely to decide to keep the pregnancy than rural respondents (OR = 5.48, 95%CI = 1.71 - 17.59). Respondents in the high socio-economic group were less likely to decide to keep the pregnancy (OR = 0.20, 95% CI=0.06-0.65). The initial reactions of the key informant interviewees to discovery of pregnancy were disappointment. In the urban area, very few pregnant adolescents were said to have continued schooling till delivery and many of them resumed school thereafter while in the rural area, they all dropped out of school. Place of residence, socio-economic status and religion were key factors influencing decision to keep adolescent pregnancy with urban dwellers more favourably disposed than rural dwellers. Intervention programmes thus need to target those in rural areas to change their views regarding keeping of adolescent pregnancies and encouraging re-integration of adolescents that get pregnant.
KNOWLEDGE, ATTITUDE AND PREVALENCE OF EARLY MARRIAGE AMONG ADOLESCENTS IN SASA, AKINYELE LOCAL GOVERNMENT AREA NIGERIA
(2013-07) ADAMS, P.
The practice of early marriage has persisted in some Nigerian tribes, despite its associated negative health effects. There is however inadequate information on adolescents’ knowledge and attitude towards this practice. This study was therefore conducted to determine knowledge, attitude and the prevalence of early marriage among adolescents in Sasa, a multi-ethnic community in Akinyele Local Government Area Nigeria. Using a three-stage sampling technique, 400 adolescents were recruited into this cross-sectional study. An interviewer-administered questionnaire was used to obtain information on socio-demographic characteristics, knowledge, attitude and prevalence of early marriage. Knowledge of early marriage and associated problems was assessed using a 15-item scale categorized as poor (<8) and good (≥8) knowledge. Attitude to early marriage was assessed with a 17-item 5-point likert scale with minimum and maximum scores of 17 and 85 respectively; scores <51 were categorized as unfavourable and ≥51 as favourable to early marriage. Data were analyzed using descriptive and Chi-square statistics. Sixty-three percent of respondents were male, majority (67.5%) were Yoruba, 26.4% were Hausa and 6.0% comprised other ethnic groups. Overall mean age was 16.1±2.3 years, the mean ages of Yoruba, Hausa and adolescents belonging to other ethnic groups were 16.4±2.0, 15.3±2.6 and 15.3±2.4 years respectively. Sixty-one percent of respondents had secondary education. Seventy-four percent of respondents had good knowledge of early marriage and associated problems. Common associated problems mentioned were deprivation of childhood (76.8%), poor child care (75.8%), obstructed labour (68.3%), high risk of vessico-vagina fistula (65.2%), poor access to contraceptives (65.2%) and high risk of HIV/AIDS (59.4%). Fifty-nine percent of respondents were not favourably disposed to early marriage. Seventy-percent of respondents reported that early marriage was a common practice in their community. Common reasons for the practice were prevention of premarital sex (88.8%), teenage pregnancy (82.7%), poverty (77.9%) and upholding tradition (72.8%). Of 23 (16%) female respondents who were currently married, 52.2% were Hausa, 39.1% were Yoruba and 8.7% were from other ethnic groups. About 74% of those currently married did so before 18 years and the majority (73.9%) of these were Muslims. The mean age at marriage was 15.7±1.9 years. The mean age at marriage for Yoruba was 16.9±1.3, Hausa (15.0±2.0) and other ethnic groups (15.5±0.7). A higher proportion of 15-19 years (78.0%) than 10-14years (59.3%) adolescents had good knowledge of early marriage and associated problems (p<0.05). Also, more 10-14 years (69.2%) than 15-19 years (32.8%) adolescents had favourable attitude to early marriage (p<0.05). Religious practice was significantly associated with early marriage with more Muslims (52.9%) than Christians (29.0%) favourably disposed to the practice (p<0.05). A higher proportion of Hausa (52.4%) than Yoruba (34.2%) had favourable attitude to early marriage (p<0.05). Adolescents in the study area have good knowledge about early marriage and its associated problems. However their attitude towards the practice was influenced by age, religion and ethnicity. Religious and cultural sensitisation of adolescents, their parents and community can help reduce this practice.
PERCENTAGE BODY FAT OF SECONDARY SCHOOL ADOLESCENTS IN IBADAN NORTH LOCAL GOVERNMENT AREA, NIGERIA
(2013-07) OYOM, C. R.
Adolescence is a transitional phase from childhood to adulthood during which significant changes in body composition occur with a tendency towards excessive fat accumulation. Determining body fat proportions at this stage of life could give an insight into the need for early intervention. The actual body fat estimates of school adolescents have not been adequately researched in Nigeria. This study was carried out to determine the Percentage Body Fat (PBF) of secondary school adolescents in Ibadan North Local Government Area, Nigeria. Using a three-stage random sampling method, 623 adolescents aged 10 to 19 years were selected from two private (141) and six public (482) secondary schools in a cross sectional study. A validated, structured interviewer-administered questionnaire was used to collect data on socio-demographic characteristics. Parents’ socioeconomic status was grouped as high, middle and low using the combination of level of education and occupation. The PBF was assessed using a Bioelectric Impedance Analyser (BIA). The participants’ PBF for age and sex were classified as low <5th, normal 5th – 95th and high >95th percentiles of the study population respectively. Data were analysed using descriptive statistics, Chi-square test, Student’s t-test, ANOVA and Pearson Correlation. Overall mean age was 14.5±2.1 years and 60.0% were female. The participants were from families in low (19.6%), middle (51.7%) and high (28.7%) socioeconomic categories. Overall, mean PBF was 12.6±7.1%. Mean PBF for male 8.5±5.6% was lower than 14.9±6.7% for female (p<0.05). There was no significant correlation between PBF and age among female (r = 0.064, p>0.05) but a significant negative correlation was observed among male participants (r = -0.224, p<0.05). Among male participants, mean PBF of low (7.8±5.2%), middle (8.3±5.5%) and high (9.2±6.1%) socioeconomic status were not significantly different (p>0.05). Similarly, there were no differences in the mean PBF of low (15.2±6.9%), middle (14.8±6.9%) and high (14.9±6.7%) socioeconomic status among female participants (p>0.05). Proportion of adolescent PBF <5th and >95th percentiles were 3.9% and 19.9% respectively. Prevalence of PBF >95th percentile was higher among male (28.1%) than female (14.4%) adolescents (p<0.05). Slightly more female participants (4.3%) than male (3.2%) had PBF <5th percentile (p<0.05). More male participants in public (31.8%) compared with 15.8% among those in private schools had PBF >95th percentile (p<0.05). There was no significant difference in prevalence of PBF >95th percentile among female participants in private (10.7%) compared with those in public schools (15.5%). There was no significant difference in the proportion of respondents who had PBF >95th percentile in low (20.5%), middle (22.4%) and high (15.1%). Similarly, proportions of participants with PBF <5th percentile in low, middle and high socioeconomic groups were 3.3%, 4.3% and 3.4% respectively were not significantly different. Male adolescents were likely to rise above 95th percentile of percentage body fat estimates for age and sex irrespective of socioeconomic status especially in public school. There is the need to initiate programmes that may enhance early identification of adolescents with the tendency of accumulating excess fat.
TEACHERS’ KNOWLEDGE, ATTITUDE AND FIRST AID CARE OF FEBRILE CONVULSION IN NURSERY AND PRIMARY SCHOOLS IN IBADAN NORTH LOCAL GOVERNMENT AREA, NIGERIA
(2014-03) ONUMADU, C.N.
Febrile Convulsion (FC) is a major cause of medical emergency in children aged six months to six years and may occur anywhere including school environment. Studies focusing on teachers’ practice of First Aid Care (FAC) to children with FC are limited in Nigeria, yet children spend substantial time under teachers’ care. This study was conducted to assess teachers’ knowledge, attitude and FAC given to children with FC among teachers in nursery and primary schools in Ibadan North Local Government Area (LGA), Nigeria. Using a two-stage sampling method, 402 teachers from 47 private and 10 public schools were recruited into this cross sectional study. A pre-tested self-administered questionnaire was used to obtain information on socio-demographic characteristics, knowledge of FC, attitude towards children with FC and FAC practice. Knowledge was measured with a 10-point item scale and categorized as good (score >4) and poor (score ≤4). Attitude was measured with a 17-item instrument, each item was scored on a 5-point likert scale with a total of 85 and categorized as poor (≤51) and good (>51). First aid care was assessed as appropriate or inappropriate based on defined protocol. Data were analysed using descriptive statistics and Chi-square test. Mean age of respondents was 35.4±10.6 years, 76.4% were female and 92.3% had post-secondary education. About 41.1% of teachers had ≤5 years teaching experience while 39.6% and 19.0% had more than 11 years and 6-10 years of experience respectively. Majority (85.3%) of respondents had heard about FC; with radio (62.7%) and television (55.2%) being common sources of information. Only 30.6% respondents had good knowledge of FC. Most (90.8%) respondents had good attitude towards children with FC, as 52.0% of respondents would not mind having their biological child play with a child with FC. However, 27% of respondents would not like to have a child with FC in their class. Reasons for the objection were: distraction in class (25.9%), inexperience of care for FC (18.5%), and avoidance of stigmatization from other pupils (14.8%). Forty-one percent of respondents had witnessed a child convulsed in school. Of these,114(69.1%) gave inappropriate care such as putting a spoon into the child’s mouth (28.1%) and pouring water on the child’s body (15.8%). Teachers with ≥11 years teaching experience (52.1%), compared to those with 6-10 years (45.0%) and those with ≤ 5 years (44.0%) had good attitude towards children who had FC (p<0.05). More male (73.5%) than female (66.7%) and more teachers with ≤5 years (76.5%) teaching experience compared to those with 6-10 years (65.6%) and those with ≤11 years (64.2%) experience gave inappropriate FAC. Sixty-eighty percent of respondents who had good knowledge of FC compared with 69.1% who had poor knowledge of FC gave inappropriate FAC. Teachers’ attitude to febrile convulsion was good while their knowledge and practices of appropriate care were poor. There is the need to design intervention programmes targeted at improving knowledge and appropriate first aid care for febrile convulsion.
Nutritional profiles and selected parental factors among children with congenital heart diseases in Ibadan, Nigeria
(The Nigeria Cardiac Society, 2015) Balogun, F. M.; Omokhodion, S. I.
"Background: Among the many adverse sequelae of congenital heart disease (CHD), malnutrition stands out as one of the major concerns. Objective: This study was undertaken to compare the nutritional status, parental age, and mid‑parental heights of children with CHD and their apparently healthy control group. Material and Methods: Electrocardiography and echocardiography were used to confirm the presence or otherwise of CHD in consecutive 100 children with CHDs and 100 age, sex, and social class matched apparently healthy control group. Nutritional parameters, parental ages, and mid‑parental heights were also obtained. Associations were tested using student t test and Chi square test. Level of significance was P < 0.05. Results: There were 54 males with CHD and the age‑range of the children was 1–96 months. The commonest acyanotic CHD was ventricular septal defect (49.0%) while the commonest cyanotic CHD was Fallot’s tetralogy (10%). Children with CHD compared with the control group had significantly lower mean z scores for weight for height, height for age, and weight for age. The mid upper arm circumference, triceps, and subscapular skinfold thickness were also lower than that found in the control group. Older parental age and lower mid‑parental heights were found among parents of children with CHD compared with those of controls. Conclusions: Malnutrition can be quite severe in children with CHD if unattended to. Early corrective intervention is necessary to prevent short‑term and long‑term sequelae of malnutrition in these children. Parental malnutrition and older parental age are likely predisposing factors to CHD."
Spectrum of behavioural abnormalities in children with nephrotic syndrome in southwestern Nigeria
(JSciMedCentral, 2015) Balogun, F. M.; Ademola, A. D.
Nephrotic syndrome is a chronic childhood disease characterized by relapses and children with this condition tend to have behavioural problems associated with the disease. These behavioural problems are usually not anticipated in most resource limited settings and can be frightening thereby making the children and the care givers to be distressed. Seven children with nephrotic syndrome who developed various behavioural abnormalities while on admission were discussed. There were four girls and three boys with age range seven to fourteen years. The abnormal behaviours noted were visual and auditory hallucinations, inappropriate speech and behaviour, attempted suicide, attention seeking behaviour and social withdrawal. These behavioural abnormalities were related to prednisolone therapy in five of the children. Diagnosis made were psychosis and delirium while treatment given included counselling, Risperidone, Halloperidol, Diazepam and reduction or withdrawal of Prednisolone. Abnormal behaviour was not anticipated in these children so the caregivers were taken unaware. This can be worse in infants or in mild cases. Most of the behavioural abnormalities were also associated with the use of prednisolone. There is an urgent need to design guidelines for the management of behavioural abnormalities in nephrotic syndrome especially steroid therapy in resource limited settings. Harmonisation of the skills of paediatric nephrologist and child psychiatrist is also important to obtain the best outcome.
How acceptable are the prevention of mother to child transmission (PMTCT) of HIV services among pregnant women in a secondary health facility in Ibadan, Nigeria?
(Association of Resident Doctors, U.C.H. Chapter, 2015) Balogun, F. M.; Owoaje, E. T.
Background: Prevention of mother to child transmission of HIV (PMTCT) programme was designed to reduce mother to child transmission (MTCT) of HIV and it has been shown to be effective. However, the uptake of the services is still very low in Nigeria. Objective : This study was designed to determine how acceptable the different services of PMTCT are to pregnant women in Ibadan, Nigeria. Method : Systematic random sampling was used to recruit 500 pregnant women attending antenatal clinic in a secondary health facility. Questionnaires were used to obtain data regarding socio-demographic characteristics, knowledge about MTCT of HIV and prevention, the awareness and attitude towards infant feeding options for HIV positive mothers. Data were analysed using student’s t test and Chi-square test with p set at 0.05. Results: Mean age of respondents was 27.4±6.1years. Most known routes of MTCT of HIV were during pregnancy (86.0%) and from breastfeeding (86.0%). More than 80% knew that having good antenatal care, appropriate supervised delivery, taking antiretroviral drugs and not breast feeding a baby are ways of PMTCT. About two thirds had a positive attitude towards HIV testing and counseling (HTC). Only 18.4% were aware of the exclusive breast feeding option for feeding infants of HIV positive mothers while 52.2% would not comply if asked not to breast feed. Women aged 35 years and above had better attitude towards non breast feeding. Conclusion : Intensified health education on the importance of HTC and promotion of exclusive breast feeding for infants of HIV positive mothers is recommended.
Atypical presentations of hypothyroidism and associated problems in Ibadan, Nigeria
(The College of Medicine, University of Ibadan, 2015) Balogun, F. M.; Jarrett, O. O.
Background: Hypothyroidism can present atypically making its recognition difficult especially in resource limited settings. Case presentation and management: Two children presented with atypical features of hypothyroidism with resultant delay in diagnosis. Patient I presented with persistent respiratory distress, facial swelling and recurrent syncopal attacks. Cardiovascular examination was normal except for pulmonary hypertension. He did not respond to conventional supportive therapy and hypothyroidism was discovered much later. Patient II was a seven month old male infant with abdominal swelling, bilateral pitting leg edema, poor weight gain and delayed developmental milestones. Examination revealed ascites and pericardial effusion. He was being managed for protein energy malnutrition until he was found to have hypothyroidism and was successfully managed with L thyroxin. Conclusion A typical presentations of hypothyroidism in resource limited settings can result in delay in diagnosis and treatment which can lead to unnecessary morbidity and mortality. High index of suspicion and expertise are therefore required.
PREVALENCE OF BODY PIERCING AND TATTOOING AND KNOWLEDGE OF ASSOCIATED HEALTH RISKS AMONG UNDERGRADUATES IN UNIVERSITY OF IBADAN, NIGERIA
(2015-06) UMOH, I. I.
Body Piercing and Tattooing (BPT) can increase the risk of contracting infectious diseases. Despite the potential harmful health consequences, the practice has remained attractive to young people. Body piercing (BP) includes piercing of various parts of the body excluding single piercing of both earlobes for females. Documented information on BPT and the awareness of its associated health risks among young people in Nigeria is few despite the practice. It is necessary to determine the prevalence, motivations for practicing BPT and awareness of the associated health risks among young people. This study was conducted to determine the prevalence of BPT and assess knowledge of associated health risks among undergraduates in University of Ibadan, Nigeria. A cross-sectional survey involving a 3-stage sampling technique using simple random and systematic methods were used to select 424 students in 34 rooms each from two male and two female halls of residence out of five and four halls respectively. A self-administered semi-structured questionnaire was used to collect information on socio-demographic characteristics, knowledge of health risks associated with BPT and practice of BPT. Knowledge of health risks associated with BPT was assessed on a 39-point scale and scores ≥20 was considered good. Data were analysed using descriptive statistics and Chi-square test at 5% level of significance. Respondents’ age was 21.4±2.3 years and 50.0% were females. Prevalence of BP was 13.2% and tattooing, 1.9%. Majority (96.8%) of pierced respondents were females. Of the pierced respondents, 74.3%, 11.4%, 8.6%, 5.7% reported ear piercing, nose piercing, navel and tongue piercings respectively. Among respondents who practised BP, 87.1% were aged 20- 25 years while 12.9% were aged 16-19 years. More than half (58.1%) of the respondents who practised BP were in higher levels (300-500) and 41.9% in lower levels (100-200) of study. Reported reasons for piercing were fun (45.8%), fashion (33.3%), personal (12.5%) and desire to put on more earrings (8.3%). Half (50.0%) of tattooed respondents were females, of which 50.0% had tattooed their legs, (25.0%) chests and (25.0%) arms. Twenty six percent of respondents had good knowledge of health risks associated with BPT and 60.0% were not aware of hygienic rules regarding BPT such as use of sterilised equipment (26.5%), single use of needle (18.9%), and use of gloves (16.1%). Many respondents were aware of some health complications associated with BPT such as HIV (90.1%), keloid (84.7%), infection of site of piercing and tattoo (73.4%) and haematoma (67.6%). There was a significant difference between sex and knowledge of health risk associated with BPT. Prevalence of body piercing and tattooing was low while knowledge of associated health risks was poor among undergraduate students of University of Ibadan. Information on body piercing and tattooing and its associated health risks should be included in life building skills education programmes for the undergraduates.
A qualitative study on stakeholders’ perception of child car safety and acceptability of selected interventions to improve child-passenger safety practices in Ibadan, Nigeria
(Nigerian Medical Association, Rivers State Branch, 2016) Olumide A. O.; Adebayo E. S.; Cadmus E. O.; Folajimi Y.; Amodu O. K.; Balogun F. M.
Background: Child car-passenger safety practices remain low in Nigeria. Findings from the formative phase of a project to deliver an m-health intervention on child-passenger safety to mothers/caregivers attending selected child-immumzation clinics in Ibadan are presented in this paper. The aim of this study was to describe stakeholders’ awareness of child passenger safety measures; to determine the cost of child car seats and acceptability of interventions to improve child-passenger safety practices. Methods: Twenty-four key-informant interviews with traffic enforcement officers (four), physicians (five), and mothers of children (fifteen) ;and a market survey was conducted. Results: Physicians and traffic law enforcement officers were more knowledgeable about child passenger safety measures compared to mothers. Cost of infant seats ranged from N6, 000.00 - N36, 000.00 (USD27.9 - USD167.67) and toddler seats, N6, 000.00 - N81, 000.00 (USD27.95 - USD377.27). Acceptance of a mobile-phone intervention and its accompanying law enforcement was very high. Conclusions: Our findings suggest that an intervention to improve child-passenger safety practices using mobile technology is acceptable to stakeholders in the study area. The intervention should address caregivers’ misconceptions about current child passenger safety measures as this could further enhance compliance with these safety measures.
Sexting: Prevalence, predictors and associated sexual risk behaviors among post-secondary school young people in Ibadan, Nigeria
(Frontiers Media, 2017) Olatunde O.; Balogun F. M.
Background and aims: Sending and receiving sexually suggestive or explicit images or texts (sexting) have been shown to be associated with health risk behaviors but liter-ature about this phenomenon is scarce in Nigeria. This study looked at the prevalence, predictors, and associated sexual risk behaviors of sexting among postsecondary school young persons in Ibadan, Nigeria. Methods: This was a cross-sectional study using a self-administered questionnaire. Data were obtained for sociodemographic characteristics and sexual orientation, sexting behavior, personality assessment (using the International Personality Item Pool Big-Five factor markers), indicators for problematic phone use (using Mobile Phone Problem Use Scale), and sexual behavior. Chi square test and logistic regression were used for data analysis with p = 0.05. Results: Five hundred seventy-five participants were recruited, age range 14–24 years, and 46.0% were males. Twenty percent had sent sexts, while 33.2% had received sexts. Fifty-four percent had high scores in extraversion, 46.5% had moderate–severe prob-lematic phone use. Sixteen percent had ever had sex, and 40.0% of these had multiple sexual partners. Males were more likely than females to have sent sexts (OR = 2.67, 95% CI: 1.68–4.24). Having a high extraversion score (OR = 2.44, 95% CI: 1.35–4.41) and moderate–severe problematic phone use (OR = 5.56, 95% CI: 2.73–11.32) was predictive of sexting. Sending and receiving of sext were significantly associated with ever having sexual intercourse (OR = 4.01, 95% CI: 2.25–7.17 and OR = 2.96, 95% CI: 1.72–5.12, respectively). Conclusion: Sexting was prevalent among postsecondary school young persons in Ibadan and was associated with male sex and problematic phone use. Intervention targeted at the identified susceptible group of young people may reduce its associated problems in this study group.
Self-reported sleep pattern, quality and problems among schooling adolescents in Southwestern Nigeria.
(Nigerian Medical Association, Rivers State Branch, 2017) Balogun F. M.; Alohan A. O.; Orimadegun A. E.
Objective: Understanding sleep patterns and related factors is vital to development in adolescence, but there is a dearth of this information among adolescents in developing countries such as Nigeria. Therefore, this study describes the sleep patterns, problems, and predictors of poor sleep quality among schooling adolescents. Methods: In a cross-sectional study design, 450 adolescents were selected and interviewed about their sleep experience and problems over the preceding one-month period using a validated form with components adapted from the Pittsburgh Sleep Quality Index (PSQI) questionnaire. Data were analyzed using descriptive statistics, c2, and logistic regression model with p set at 0.05. Results: The mean age of respondents was 13.4 ± 1.2 years. Only half (50.2%) had a global PSQI score of <6, suggesting little or no difficulty with sleep. Significantly, a higher proportion of respondents spent a short time in bed before sleep, _15 min among those who had good sleep quality (81.4%) compared with those who had poor sleep quality (65.2%) (p < 0.001). The odds of having poor sleep quality was significantly higher in the subgroup who had _8.5 h sleep than those who had 8.5 h sleep or more (adjusted odds ratio ¼ 4.62; 95% confidence interval ¼ 2.61, 8.17, p < 0.001). Conclusion: Remarkably poor sleep quality exists among schooling adolescents in Ibadan, Nigeria, and sleep problems are prevalent, especially among those with short sleep duration.
Knowledge of HIV and intention to engage in risky sexual behaviour and practices among senior school adolescents in Ibadan, Nigeria
(Faculty of Basic Medical Scienecs, University of Ibadan. Ibadan, 2018) Ajide K. B.; Balogun F. M.
A high proportion of adolescents still engage in risky sexual behaviours that put them at risk of infection complications of risky sexual behaviours including Human Immunodeficiency Virus (HIV) infection despite the different interventions already in place. This study was designed to determine the adolescents’ knowledge of HIV, intention to engage in risky sexual behaviour and sexual practices. A 3-stage sampling technique was used to select 240 adolescents in senior secondary schools in Ibadan, Nigeria. Data were obtained using a pretested, semi-structured, self-administered questionnaire. Data were analysed using descriptive statistics and Chi-square test at 5% level of significance. The mean age of the respondents was 16.3±1.4 years and 126(52.5%) were females. Only 34.3% had good knowledge of HIV and there were misconceptions about its transmission. Most of the respondents (95.0%) had intention to engage in risky sexual behaviour and those with good knowledge of HIV were willing to engage in risky sexual behavour with familiar people. Good knowledge was associated with intention to engage in low-risk sexual behaviour. Seventy-nine (32.9%) were sexually active and they had better knowledge of HIV. Knowledge of HIV was low among this study group and was not associated with their intention to engage in risky sexual behaviour. There is need for more effective and appropriate school and community-based intervention programmes which can impact positively on the adolescents’ sexual behaviour.
The state of adolescent immunization in Nigeria: A wake up call for all stakeholders
(The PAMJ, 2019) Balogun, F. M.
The number of children who survive to adolescence is increasing in Nigeria, significantly due to the success of child survival programs, with immunization as a major theme. However, the national immunization schedule in Nigeria is presently restricted to early childhood with no attention paid to immunization in adolescence. Presently, the vaccines that are readily available for adolescents include tetanus toxoid which is normally administered to pregnant women, so necessarily includes adolescent mothers; and a few research programs which offers hepatitis B vaccines. Also, there are few Nigerian adolescents who access immunization as a requirement for travelling outside the country or as a result of parental effort. Knowledge and awareness about adolescent immunization is generally poor. Nigerian adolescents have been shown to be poorly protected from tetanus, rubella and hepatitis B which are vaccine preventable. Neonatal, childhood and adult tetanus, congenital rubella syndrome, cervical cancer and hepatocellular carcinoma are just few of the diseases whose incidence can be reduced with an effective adolescent immunization program. This will also ensure that the gain of childhood immunization is concretized and socio-economic losses as a result of vaccine preventable diseases are eliminated to create a healthy and vibrant workforce. There is an urgent need to build a viable adolescent immunization program in Nigeria as adolescents represent a window of opportunity to prevent diseases which affect both the younger and older age group. This can be extended to other developing countries as well.
Recognition and Disclosure of Medical Errors Among Residents in Surgical Specialties in a Tertiary Hospital in Ibadan
(Springer Nature, 2019) Balogun J. A.; Adekanmbi A.; Balogun F. M.
Background Medical error (ME) remains central to discussions regarding patient’s safety and its frequency appears high in surgical specialties because of some peculiarities. We set out to study the perception of surgical residents about medical errors, their ability to recognize them and predisposition to disclosing their errors. Methods This was a cross-sectional study among surgical residents at the University College Hospital, Nigeria. Data about their knowledge, perception and recognition of medical errors were obtained. Knowledge and practice of medical error disclosure was also examined. Each of these was scored on Likert scale and scores categorized. Chisquare test and logistic regression were used for analysis with p at\0.05. Results 92 residents participated and 11(12.0%) were females. 32.6% of the respondents had less knowledge about medical errors and these were significantly junior residents. Residents with poor perception about ME were 43.5% and recent involvement with ME was significantly associated with good perception about ME. Delay in obtaining consultation and delay in diagnosis were identified respectively as MEs by only 40(43.5%) and 31(33.7) of the Participants. While 82(89.1%) agreed that all errors should be reported to the consultant, only 20(21.7%) believed patients/relatives should be informed of all errors, while 49(53.3%) were well disposed to disclosing ME. Only 4(4.3%) residents had a formal training on ME. Conclusions Knowledge of ME was low among junior residents and residents are less likely to disclose error to patients/relatives. A formal training on ME will impact on their recognition, practice, and disclosure of ME.
Perception of in-school adolescents about adolescent-friendly characteristics of healthcare services received in Ibadan metropolis, Nigeria
(Association of Resident Doctors, U.C.H. Chapter, 2019) Adeleke O.; Balogun F. M.
Introduction: Adolescence was previously assumed to be a diseases free stage of life. It is however now known that adolescents are not only involved in risky health behaviours but they also have their own share of health problems that other age groups face. The adolescent-friendly model helps to create adolescent-responsive health systems, Nigeria currently has no country-specific report on the adolescent friendly characteristics of the health services rendered to her adolescents. This study identified various health problems for which in-school adolescents in Ibadan North- East Local Government Area sought healthcare and determined their perception of received healthcare services with regards to its “adolescent-friendliness”. Methods: This was a school-based cross-sectional study that utilized quantitative method of data collection. A multi-stage systematic random sampling technique was employed to select 500 students for school survey. Self-administered, semi structured questionnaire was used to collect data. Descriptive statistics and Chi-square test at =0.05 were used for data analysis. Results: Perceived malaria (52.4%), acne (36.2%), menstrual pain (17.0%) and depression (3.0%) were the common health problems adolescents sought health care for. Majority of the adolescents perceived the health services received as being adolescent-friendly. These health services were perceived to be accessible by (87%), acceptable by (93.2%), appropriate by (81.4%), effective by (91.4%), and equitable by (82.2%) of the respondents. Adolescents who sought mental care perceived least adolescent-friendliness of received healthcare services. Conclusion: Adolescents in Ibadan currently view received health services as adolescent-friendly. However, the management of mental health problems in adolescents should incorporate adolescent friendly elements entrenched at every level of the health system.