Institute of Child Health

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Comparison of Haematologic parameters among adolescents with and without asymptomatic malaria in Ibadan, Nigeria
(Olad Resolution Print, 2022) Balogun F. M.; Ademola S. A.; Olutogun T.
Background and Objectives: Asymptomatic malaria results from partial immunity resulting from recurrent exposure to the malaria parasite and it has been shown not to be benign as it was earlier believed. Adolescents are likely to have partial immunity to malaria which can predispose them to the asymptomatic form of malaria, but malaria is understudied in this age group. This study was conducted to compare the haematologic parameters among secondary school adolescents with and without asymptomatic malaria in Ibadan. Methods: A cross-sectional study was conducted and data regarding sociodemographic characteristics, presence or otherwise of malaria parasite (using microscopy) and haematological parameters (obtained using haematology auto- analyser and microscopy) were documented. Malaria parasite density was categorised as 1-100 and >100/μL. Other haematological parameters were classified as categorical variables. Associations were determined using Chi square test and level of significance was p<0.05. Results: A total of 103 students were recruited with a mean age of 15.6±2.02 years and 61(59.2%) were boys. Those from the low socioeconomic class were 86 (83.5%), 24 (23.3%) had asymptomatic malaria while 22 (21.4%) had parasite density of >100/μL. Haematological abnormalities detected were anaemia (11.7%), leucopenia (4.9%), thrombocytopenia (11.7%), reduced MCV and reduced MCH (88.3%). All participants had low MCHC. Abnormal peripheral blood film was found in 79.5% but this was not associated with the presence of malaria parasite. Older adolescence (age ≥ 15 years) was significantly associated with parasite density of>100/μL (p = 0.02) and a higher proportion of those from the low socioeconomic class had asymptomatic malaria (24.4% vs 17.6%). Conclusion: Although some haematologic parameters of the study participants were affected by asymptomatic malaria, there were other unexplained blood abnormalities. There is a need to address asymptomatic malaria among these adolescents and other causes of abnormal blood profile should be tackled.
Facilitators and barriers of healthcare workers’ recommendation of HPV vaccine for adolescents in Nigeria: views through the lens of theoretical domains framework
(BioMed Central., 2022) Balogun F. M.; Omotade O. O.
Background: The human Papillomavirus (HPV) vaccine has demonstrated efficacy in the prevention of cervical cancer when given in early adolescence. The recommendation of the vaccine by health care workers (HCW) is crucial to the uptake of the vaccine by adolescents and the process of this recommendation is important as it determines subsequent uptake of the vaccine. Understanding of the facilitators and barriers of recommendation of this vaccine can help in the development of strategies to improve its recommendation rates and uptake. This study therefore explored the facilitators and barriers for the recommendation of HPV vaccine for adolescents by HCW in Ibadan, Nigeria using the Theoretical Domain Framework (TDF). Methods: Key informant interviews were conducted with 14 purposively selected HCW who were in charge of vaccination. Content analysis was used after deductive coding of the data using the domains of the TDF. Relevant concepts for facilitators and barriers of HPV vaccine recommendation and quotes were then identified. Results: Mean age of the HCW was 47.7 ± 6.5 years and they consisted of eight nurses, four medical doctors, one medical social worker and one health visitor. Ten domains of the TDF were represented among the facilitators and barriers against the recommendation of HPV vaccination by the HCW, except the goals; memory, attention, decision process; emotion; and behavioral regulation domains. The domains with the highest frequency of concepts were: knowledge, skills, social/professional role and identity, beliefs about capabilities, beliefs about consequences, intention and environmental context and resources. Domains with conflicting statements in the concept were: environmental context and resources, and beliefs about consequences. While those with perceived strength of concept were: social influences, reinforcement and optimism. Conclusion: All the 10 identified domains of the TDF are potential areas of focus for strategies for improving the recommendation of HPV vaccine for adolescents by health care workers in Nigeria and other countries with similar sociocultural settings.
She must have been sleeping around” Contextual interpretations of cervical cancer and views regarding HPV vaccination for adolescents in selected communities in Ibadan, Nigeria
(PLoS ONE, 2018) Balogun F. M.; Omotade O. O.
Background Human Papilloma virus (HPV) vaccines for adolescents are pivotal in the control of cervical cancer, the commonest women specific malignancy in sub-Saharan Africa. Knowledge about cervical cancer have been reported to be low in Africa but expressed acceptability for HPV vaccines have been high. The reason for this mismatch is not clear. An understanding of the interpretation of cervical cancer and views about HPV vaccine are important as they can affect actual decision making regarding adolescents' uptake of HPV vaccine. This study explored contextual interpretations of stakeholders regarding cervical cancer and HPV vaccines for adolescents in five selected communities in Ibadan, Nigeria. Methods Qualitative data were collected through twenty focus group discussions among parents of adolescents, religious and traditional leaders, school teachers and adolescents; and four key informant interviews with the identified traditional healers in the selected communities. Constant comparison analysis was done after transcription. Results Almost every group had at least one person who had seen a cervical cancer patient. Cervical cancer was widely viewed as being caused by promiscuity of women while older participants believed that the alteration of lifestyle by civilization was a major contributory factor. There was also a general notion that it was due to a curse. The role of HPV was generally not known. Most participants were favorable towards HPV immunization for adolescents, but traditional healers and some religious leaders were not. The high cost of the vaccines and possibility of side effects where the main concerns about the introduction of HPV vaccine. Decision to take the vaccine rest with the fathers whose views were heavily influenced by traditional and religious leaders. Conclusions Awareness about cervical cancer may not be as low as earlier reported and there were many misconceptions about cervical cancer in the study communities. It is important to address these misconceptions to ensure successful introduction of HPV vaccine for adolescents in future.