Adetanwa I. Odebiyi

Acceptability of prenatal diagnosis of sickle cell anaemia (SCA) by female patients and parents of SCA patients in Nigeria

The acceptability of prenatal diagnosis (PND) of sickle cell anaemia (SCA) as a means of controlling sickle cell disorder in Nigeria was examined using a structured questionnaire. The respondents were comprised of 92 adult female patients with SCA, aged 15-20 (23 +/- 6) years; 53 HbAS mothers, aged 20-61 (37 +/- 11) years and 48 HbAS fathers, aged 33-65 (46 +/- 8) years. More than 85% of the respondents would like PND to be offered in Nigeria and 92% of the HbAS mothers as well as 86% of the fathers would like to have the investigation or allow their wives to go through the procedure, respectively. Only 35% of the patients as compared to 63% of the mothers and 51% of the fathers would opt for termination of an affected pregnancy. Fear of the complications of abortion and religious convictions were the two most frequently cited reasons for opposing pregnancy termination. The high percentage of parents who would opt for termination of an affected pregnancy was associated with the societal emphasis on perfection and on previous experience in management of SCA patients. It is interesting that most of the respondents still favoured effective genetic counselling as the best means of controlling SCA.

Scientific rationale for study design of community-based simplified antibiotic therapy trials in newborns and young infants with clinically diagnosed severe infections or fast breathing in South Asia and sub-Saharan Africa

Background: Newborns and young infants suffer high rates of infections in South Asia and sub-Saharan Africa. Timely access to appropriate antibiotic therapy is essential for reducing mortality. In an effort to develop community case management guidelines for young infants, 0–59 days old, with clinically diagnosed severe infections, or with fast breathing, 4 trials of simplified antibiotic therapy delivered in primary care clinics (Pakistan, Democratic Republic of Congo, Kenya and Nigeria) or at home (Bangladesh and Nigeria) are being conducted. Methods: This article describes the scientific rationale for these trials, which share major elements of trial design. All the trials are in settings of high neonatal mortality, where hospitalization is not feasible or frequently refused. All use procaine penicillin and gentamicin intramuscular injections for 7 days as reference therapy and compare this to various experimental arms utilizing comparatively simpler combination regimens with fewer injections and oral amoxicillin. Conclusion: The results of these trials will inform World Health Organization policy regarding community case management of young infants with clinical severe infections or with fast breathing.

Cancer and ageing in Ibadan: a sociological analysis.

Abstract This is a study that tried to examine the possible socio economic factors involved with the low reported rate of cancer among the older age groups in Ibadan. We took some age samples (the youngest and the older age groups) in the older parts of Ibadan and examined their medical habits in relations to hospital attendance vis-a-vis traditional medicine. The older age groups are mostly farmers who have farms at the outskirts of the city and keep goats and poultry runs within their compounds. They believe implicitly in the traditional medicine which they have never had cause to doubt. If a case worsens after the use of the traditional medicine, they never attribute the failure to the medicine itself, rather they attribute it to the method of application or to destiny. The younger age groups, on the other hand who are on a higher socio-economic level, tend to prefer hospital treatment. The finding that among the older age groups, respondnets reported a stronger preference for traditional medicine than among the younger age groups supports the hypothesis that the reported low rate of cancer among the older age groups is due to a differential selective mechanism, i.e. cancer in old Ibadan people is under-reported.

Why not Bathe the Baby Today?: A Qualitative Study of Thermal Care Beliefs and Practices in Four African Sites.

BackgroundRecommendations for care in the first week of a newborn’s life include thermal care practices such as drying and wrapping, skin to skin contact, immediate breastfeeding and delayed bathing. This paper examines beliefs and practices related to neonatal thermal care in three African countries.MethodsData were collected in the same way in each site and included 16–20 narrative interviews with recent mothers, eight observations of neonatal bathing, and in-depth interviews with 12–16 mothers, 9–12 grandmothers, eight health workers and 0–12 birth attendants in each site.ResultsWe found similarities across sites in relation to understanding the importance of warmth, a lack of opportunities for skin to skin care, beliefs about the importance of several baths per day and beliefs that the Vernix caseosa was related to poor maternal behaviours. There was variation between sites in beliefs and practices around wrapping and drying after delivery, and the timing of the first bath with recent behavior change in some sites. There was near universal early bathing of babies in both Nigerian sites. This was linked to a deep-rooted belief about body odour. When asked about keeping the baby warm, respondents across the sites rarely mentioned recommended thermal care practices, suggesting that these are not perceived as salient.ConclusionMore effort is needed to promote appropriate thermal care practices both in facilities and at home. Programmers should be aware that changing deep rooted practices, such as early bathing in Nigeria, may take time and should utilize the current beliefs in the importance of neonatal warmth to facilitate behaviour change.

Liberia's Child Soldiers: Prospects and Problems

The end of the cold war gave rise to expectations that Africa would benefit from the peace dividend. The euphoria was however short lived. In Liberia, a bloody civil war broke out in 1989 in which thousands of children were used as child soldiers. Surprisingly, not much is known about how they are settling back into civil society after the end of hostilities. This study tries to fill that gap by focusing on the role of social support networks in their rehabilitation. It was found that while civil society is supportive of their rehabilitation, government policies do not target child soldiers. Two NGOs, Don Bosco Homes and Children Assistance Programme, are actively involved in their rehabilitation, and have made tremendous progress in that regard. They face numerous problems: lack of space and funds, inadequate employment opportunitie~ for rehabilitated child soldiers, and non-availability of electricity and water supply. To facilitate the rehabilitation process, there is urgent need to improve the security situation in Liberia to attract domestic and foreign investment and create jobs. It is also important for Charles Taylor to see himself as president of Liberia, and not just the National Patriotic Front, NPLF. Government should respect the fundament rights of citizens, as perceptions of Charles Taylor as a renegade has made the country unattractive to donors, thereby frustrating its post war reconstruction programmes. The international community must not abandon Liberia, but should engage it conditionally, to promote good governance and avoid another bloody contest for power in that country.