Adedeji Onayade

Infant feeding intentions and practices of HIV-positive mothers in southwestern Nigeria.

It has been shown that infant feeding pattern affects mother-to-child transmission of HIV. This study reports the infant feeding practices of HIV-positive mothers in southwestern Nigeria. J Hum Lact. 24(3):303-310. Este estudio investigó factores que determinan las intenciones de alimentación infantil y las prácticas verdaderas de 104 mujeres embarazadas infectadas con el VIH en el suroeste de Nigeria desde Enero del 2004 a Junio del 2006. Ellas recibieron conserjería como se recomienda en las directrices de alimentación infantil de la OMS y seguimiento mensual durante 6 meses postparto. Entre ellas, 71 (68.3%) y 33 (31.7%) planeaban lactancia materna exclusiva (LME) y alimentación de reemplazo exclusiva (ARE) respectivamente. Las madres con compañeros que sabían que eran VIH positivos, que habían revelado su estado de VIH a sus familiares/ amigos, y que tenían historia de un hijo muerto planearon ARE. De 84 parejas madre-hijo que completaron el estudio, 9 (15.5%) y 13(50%) de aquellas que tenían la intención de LME y ARE respectivamente practicaron alimentación mixta (p = 0.001). Se concluyó que la mayoría de madres infectadas con VIH que recibieron conserjería basada en las recomendaciones de la OMS prefirieron LME. Las madres que habían revelado su estado de VIH, con historia de hijo muerto y con esposo que sabia que era VIH positivo practicaron mas la ARE.

Challenges Unique to the Design of a Comprehensive Questionnaire Assessing Breast Cancer Risk Factors Among Women in Sub-Saharan Africa

Summary: We assessed the efficacy of a pilot questionnaire designed to elicit information about external risk factors for breast cancer in sub-Saharan African women. Preliminary analysis identified areas of the questionnaire and interviewing process that required modification, as well as socioeconomic factors that contribute to reduced participation among these understudied populations.

Relating self-perceived with objective risk for breast cancer among women in rural and urban communities in southwestern Nigeria -

Background: In an effort to enhance the value of early detection of breast cancer, attempts are now being made to relate a woman’s perceived risk of developing breast cancer with her actual risk. Women at increased risk but who underestimate this risk may unnecessarily defer the benefits of screening. Objective: To compare the self-perceived risk for developing breast cancer with their objective risk, as determined by the objective breast cancer risk (OBCR) and the Gail’s risk score. Materials and Methods: Quantitative methods utilized a cross-sectional comparative study design. Six hundred and eighty women aged 20 years or older were interviewed using a semi-structured, interviewer-administered questionnaire and selected using a multistage sampling technique from two predominantly rural and urban local government areas. A study set criteria on the OBCR was determined and classified into average or high risk for developing breast cancer (AOBCR and HOBCR, respectively), based on whether or not the respondent showed any of the two of four strong risk factors for breast cancer. Objective risk was also determined using an Internet-based Gail’s breast cancer assessment tool. Quantitative data were analyzed using SPSS software, version 16.0. Qualitative methods comprised focus group discussion sessions for women in both rural and urban areas, which were analyzed using detailed content analysis, and the results were presented in Z–Y tables. Result: The result of this study suggested that majority of women did not accurately assess their risk of developing breast cancer as nine in 10 women at high risk underestimated their true risk of developing breast cancer. Using the study set criteria, about one in 20 respondents were assessed to have HOBCR. Among women in rural communities, about 95% and 4% revealed AOBCR and HOBCR, compared with 93% and 11% of women in urban communities showing AOBCR and HOBCR, respectively. The Gail’s risk assessment tool was able to classify just two (5.6%) respondents as being at a high risk of developing breast cancer. The sensitivity of the Gail’s model when applied to the respondents was 5.56%. Conclusion: The study showed that OBCR has a potential of being used as a high-risk screening tool for breast cancer in middle- or low-resource setting. Therefore, clients who screen positively as HOBCR can subsequently be offered targeted screening, intensive health education, and counseling on various risk-reducing options.

Radiation protection and dose awareness among doctors in a Nigerian Teaching Hospital: A preliminary study

Background: Medical imaging using ionizing radiation is an essential tool for diagnosis. Ionizing radiation has adverse biological effects on living organisms and the risk of adverse effects increases with higher doses of radiation. It is the duty of the requesting doctor to balance the risks and benefits of imaging tests involving the use of ionizing radiation. However, previous studies reveal that doctors′ knowledge regarding the radiation doses incurred during diagnostic radiological procedure is inadequate. Aims: To assess doctors′ knowledge about the guiding principle of radiation protection (As Low as Reasonably Possible (ALARA)) and their knowledge of the radiation doses their patients receive during some common radiological procedures. Materials and Methods: We adapted the questionnaire used in a previous study and circulated it among 120 doctors from different specialties and cadres. There were questions about cadre, years in medical practice, specialty, and attendance at any training on radiation protection. We asked about nonmedical sources of radiation, the full meaning of ALARA, and the effective doses of ionizing radiation that patients receive during common radiological investigations proportional to chest X-ray. Responses were scored out of a total of 10 marks. Results: One hundred and twenty doctors participated in the study; 27 radiologists and 93 nonradiologists. The total scores ranged from 1 to 7 marks (mean score=3.38, median score=3.0). Overall, the doctor′s total scores were significantly affected by their specialty and exposure to previous training on radiation protection, with P=0.001 and P=0.001, respectively. Scores were not significantly affected by number of years post qualification. Conclusion: Level of awareness about the basic principle of radiation protection and patients′ exposure is poor among our study population