Eme T. Owoaje

Incidence and pattern of injuries among residents of a rural area in South-Western Nigeria: a community-based study

BackgroundDespite the high incidence of infectious diseases in developing countries, injuries still contribute significantly to the health burden. There are few reports of rural, community-based injury surveys in Nigeria. This study describes the incidence and pattern of injuries among the residents of a rural area in South-Western Nigeria.MethodsIt was a community based cross-sectional study. Two of six census areas were randomly selected and all households in the two areas visited. Information on the sociodemographic characteristics, individual injury events and outcomes was obtained with a questionnaire. Data were analyzed using SPSS version 11.ResultsInformation was obtained on the 1,766 persons in 395 households. Fifty-nine injuries were recorded by 54 people, giving an injury incidence of 100 per 1,000 per year (95% CI = 91.4–106.9). Injury incidence among <30 years was 81.6 per 1,000 per year (95% CI = 62.3–83.1); and 126 per 1,000 per year (95% CI = 98.2–137.4) for those ≥ 30 years (p = 0.013). Injury incidence for females was 46 per 1,000 per year; and 159 per 1,000 per year (p = 0.000) for males. A significantly higher proportion of males (5%) sustained injury compared to females (2%) (p = 0.043). Falls and traffic injures, 15 (25%) each, were the leading causes of injury; followed by cuts/stabs 12 (21%), and blunt injuries, 9 (15%). Traffic injuries were the leading cause of injuries in all age groups except among the 5–14 years where falls were the leading cause of injury. In thirty-four (58%) of those injuries, treatment was at a hospital/health centre; while in two (3%), treatment was by untrained traditional practitioners. Thirty-nine (66%) of the injuries were fully recovered from, and 19 (32%) resulted in disability. There were 2 fatalities in the 5-year period, one (2%) within the study period.ConclusionInjuries were common in Igbo-Ora, though resultant disability and fatality were low. Males and those aged ≥ 30 years had significantly higher proportions of the injured. Falls and traffic injuries were the most commonly reported injuries. Appropriate interventions to reduce the occurrences of injuries should be instituted by the local authorities. There is also need to educate the community members on how to prevent injuries.

Comparative study of mental health and quality of life in long term refugees and host populations in Oru-Ijebu, Southwest Nigeria

BackgroundRefugees as “People Living in Highly Stressful Situation” are particularly vulnerable to mental ill-health as a result of the trauma experienced pre- and post-migration. The lack of information on the mental health disparities of refugees and non-refugees in West Africa is what this study aimed to bridge.A cross-sectional study design was employed using a cluster sampling technique. Interviewer-administered structured questionnaires consisting of the Mini-International Neuropsychiatric Interview (MINI), WHO quality of life (WHOQOL-BREF) and the Community Quality of Life (CQoL) were used for data collection. Data were analyzed with SPSS version 17. Logistic regression analysis was used to determine the predictors of mental health status and QoL.ResultsRespondents consisted of 444(45.7%) refugees and 527(54.3%) non-refugees. Two-thirds 292 (66%) of the refugees were Liberians. Mean age: refugees - 34.8u2009±u200912.8u2009years versus non-refugees - 33.3u2009±u20098.1u2009years (pu2009<u20090.05). While the majority 376(84.7%) of the refugees were married, most 468(88.8%) of the native population were not (pu2009<u20090.001). Significantly higher proportion of refugees had polygamous marriages, lived in poorer type of accommodation and had no formal education compared to the non-refugees (pu2009<u20090.05). The overall QoL and CQoL scores were both significantly lower for the refugees (pu2009<u20090.001). Refugees were three times more likely than non-refugees to have poor mental health [OR: 3.43; 95%CI: 1.83-6.40]. Overall, being currently ill tripled the odds of mental ill health [OR: 2.73; 95%CI: 1.98-3.77]. Unskilled workers [OR: 2.78; 95%CI: 1.68-4.60], skilled workers [OR: 2.98; 95%CI: 2.03-4.38] and the unemployed [OR: 1.94; 95%CI: 1.29-2.92] had two or more times the odds of poor mental health compared to professionals.ConclusionsQoL and occupational status were the major threats to the mental health of the refugees. Results of this study point to the need for continued attention to not only the healthcare needs but the welfare, housing, employment and overall QoL to support the long-term mental health of refugees and non-refugee populations alike.

Social network as a determinant of pathway to mental health service utilization among psychotic patients in a Nigerian hospital

OBJECTIVEnThe main objectives of the study were to determine the relationship between social network and pathway to service utilization among psychotic patients.nnnMATERIALS AND METHODSnThis descriptive study was carried out in a psychiatric unit in a general hospital in South West Nigeria. Using structured questionnaires, primary data were collected from 652 psychotic patients on their social network, health behaviors and pathway to current service use. Logistic regression analysis was used to assess the effect of social network on patients use of services, controlling for sociodemographics, health and functional status.nnnRESULTSnMean age of the respondents was 29.0 ± 7.5 years, range 14-58 years, males constituted 52.6%. Regarding pathway to services, alternative sources of care such as priests, spiritualists, natural therapists, herbalists, was the first port of call for 78.9% of respondents. Family dominated the social network in 51.1% of patients. The presence of some social network and social support structures were significantly associated with the use of general medical and specialty psychiatric services for patients with schizophrenia (P = 0.03), schizoaffective disorder (P = 0.02), bipolar I disorder (P = 0.01), but not with major depression and symptoms of psychological distress.nnnCONCLUSIONSnFindings indicate that social support and social network enhanced utilization of mental health services for psychiatric patients except for those with psychotic depression or those with symptoms of psychological distress. In addition, alternative sources of care are still relevant in mental health service delivery in South West Nigeria.

Intimate partner violence among women in a migrant community in southwest Nigeria.

This descriptive cross sectional study was conducted to determine attitudes to and the prevalence of intimate partner violence (IPV) among women of reproductive age in a migrant community in southwest Nigeria. All consenting females aged 15–49 years in the area sampled were interviewed. A structured questionnaire administered in the local language was used to obtain information on attitudes toward IPV in seven hypothetical situations as well as their exposure to IPV. Eighty-seven percent of women had ever experienced IPV, while 20% experienced IPV in the preceding 12 months. Regarding attitudes to IPV, 79.5% of women believed that wife beating was justified in at least one of seven situations. Respondents who were not living with a male partner were more likely than their counterparts who were married/cohabiting to accept IPV (p = 0.03). There is a need for a cultural reorientation through appropriate health education interventions.

Intimate Partner Violence in Southwestern Nigeria: Are There Rural-Urban Differences?

The researchers in this study assessed the prevalence of different types and experience of intimate partner violence among 600 women aged 15 to 49 years in selected rural and urban communities in southwestern Nigeria between October and December, 2007. Lifetime prevalence of intimate partner violence was 64% in the rural and 70% in the urban areas. Controlling behavior was the most frequently reported type of intimate partner violence experienced by both groups of women, and sexual violence was reported least. More urban women reported sexual violence and controlling behaviors than rural women (16.4% versus 11.6% and 57.7% versus 42.0%, respectively). More rural women had experienced physical violence (28% versus 14%). More urban women experienced controlling behaviors, while more rural women experienced physical violence. In both locations, history of partners involvement in physical fights was significantly associated with reporting sexual violence (rural: odds ratio [OR] = 3.9; 95% confidence interval [CI] 1.2–12.3; urban: OR = 8.4; 95% CI 1.4–51.8). History of alcohol consumption by partners was significantly associated with reporting physical violence (rural: OR = 2.3; 95% CI 1.2–4.4; urban: OR = 3.2; 95% CI 1.4–7.2). However, among rural respondents, younger partners were more likely to perpetuate controlling behavior (OR = 5.1; 95% CI 1.7–15.6) and being in a relationship for ≥10 years was related to psychological and physical violence. Among urban respondents, history of partners involvement in physical fights was associated with controlling behavior (OR = 8.2; 95% CI 1.1–65.4) and physical violence (OR = 4.5; 95% CI 1.2–17.3). These results suggest that intimate partner violence is a frequent experience in women in both communities, although the types of intimate partner violence experienced differed, and multidisciplinary strategies are required to reduce intimate partner violence.

Sexual harassment experiences of female graduates of Nigerian tertiary institutions.

The sexual harassment experiences of female graduates from tertiary institutions in Nigeria, were explored using self-administered questionnaires. Information was obtained on the respondents socio-demographic characteristics and experiences of sexual harassment while in their various tertiary institutions. The majority (69.8%) of the respondents had been sexually harassed, with the main perpetrators being male classmates and lecturers. About two-thirds experienced the non-physical type of sexual harassment; 48.2% experienced the physical type. Non-physical harassment included sexual comments (57.8%) and requests to do something sexual in exchange for academic favors (32.2%). Physical forms of sexual harassment included unwanted sexual touching (29.4%) and being intentionally brushed against in a sexual way (28.9%). The effects experienced by victims were depression and perceived insecurity on campus. Sexual harassment is a common occurrence in Nigerian tertiary institutions. Appropriate institutional interventions should be developed to reduce these occurrences.

A rural-urban comparison of client-provider interactions in patent medicine shops in South west Nigeria.

The increasing prominence of patent medicine vendors (PMVs) in healthcare provision makes information about how they operate of interest. This study assessed consumers behavior and PMVs performance in the treatment of childhood illnesses in rural and urban communities in South West Nigeria. Non-participatory observations were carried out in 163 licensed patent medicine stores in Oyo State, Nigeria. Many PMV shops (70.6% rural and 61.9% urban; p = 0.141); stocked non proprietary drugs. Clients often requested for drugs by name (75.4% urban versus 62.2% rural; p = 0.002) and PMVs mostly sold drugs as requested without questions (65.3% urban 57.8% rural; p = 0.07). Inappropriate treatment practices and invasive procedures were observed more often in urban PMVs shops (p < 0.001). PMVs functioned mostly as sales persons supplying clients drug requests. Strategies to improve PMV treatment practices should include caregiver education to be effective.

Barriers to and determinants of the use of intermittent preventive treatment of malaria in pregnancy in Cross River State, Nigeria: a cross-sectional study

BackgroundMalaria in pregnancy (MIP) has serious consequences for the woman, unborn child and newborn. The use of sulfadoxine-pyrimethamine for the intermittent preventive treatment of malaria in pregnancy (SP-IPTp) is low in malaria endemic areas, including some regions of Nigeria. However, little is known about pregnant women’s compliance with the SP-IPTp national guidelines in primary health care (PHC) facilities in the south-south region of Nigeria. The aim of this study was to identify the barriers to and determinants of the use of SP-IPTp among pregnant women attending ANC in PHC facilities in Cross River State, south-south region of Nigeria.MethodsA cross-sectional survey was conducted in 2011 among 400 ANC attendees aged 15–49 years recruited through multistage sampling. Binary logistic regression was used to determine the factors associated with the use of SP-IPTp in the study population.ResultsUse of SP-IPTp was self-reported by 41xa0% of the total respondents. Lack of autonomy in the households to receive sulfadoxine-pyrimethamine (SP) during ANC was the main barrier to use of IPTp (83xa0%). Other barriers were stock-outs of free SP (33xa0%) and poor supervision of SP ingestion by directly observed treatment among those who obtained SP from ANC clinics (36/110u2009=u200933xa0%). In the multivariate logistic regression, the odds of using SP-IPTp was increased by the knowledge of the use of insecticide treated nets (ITNs) (ORu2009=u20092.13, 95xa0% CI: 1.70–3.73) and SP (ORu2009=u200922.13, 95xa0% CI: 8.10–43.20) for the prevention of MIP. Use of ITNs also increased the odds of using SP-IPTp (ORu2009=u20092.38, 95xa0% CI: 1.24–12.31).ConclusionsUse of SP-IPTp was low and was associated with knowledge of the use of ITNs and SP as well as the use of ITNs for the prevention of MIP. There is a need to strengthen PHC systems and address barriers to the usage of SP-IPTp in order to reduce the burden of MIP.

Experience and attitude of rural women to IPV in Nigeria

AimIn Nigeria, few studies that have addressed intimate partner violence (IPV) to women have been carried out in urban settings. The purpose of the study was to determine the prevalence, types and factors associated with experience of IPV among rural women in Oyo State, Nigeria. Attitude to wife beating was also assessed.Subject and methods300 rural women aged between 15 and 49xa0years selected by multistage sampling method were interviewed using semi-structured interviewer administered questionnaire.ResultsLifetime prevalence of IPV was 64.0xa0%, controlling behavior was 42.0xa0%, psychological violence −34.7xa0%, physical violence −28.0xa0% and sexual violence −11.6xa0%. Predictors of controlling behavior were monthly incomeu2009>u2009

Knowledge and perception of Prevention of Mother to Child services amongst pregnant women accessing antenatal clinic in a Primary Health Care centre in Nigeria

67(ORu2009=u20092.2; 95%xa0CI: 1.2–4.1) and age of partner ≤34xa0years (ORu2009=u20092.8; 95xa0% CI: 1.3–6.2). Respondents in relationship for more than 10xa0years were more likely to experience psychological violence (ORu2009=u20095.7; 95xa0% CI 2.1–15.2). Predictors of physical violence were being in relationship for ≥3xa0years (ORu2009=u20093.8; 95xa0% CI: 1.1–13.3) and partner consuming alcohol (ORu2009=u20092.1; 95xa0% CI: 1.1–4.1). Partner’s educational level (at least secondary) (ORu2009=u20095.7; 95xa0% CI: 1.2–24.6) and alcohol consumption (ORu2009=u20093.0; 95xa0% CI: 1.3–6.7) were predictors of sexual violence. About 24.4xa0% of women justified wife beating. The most common reason for justification was that the woman had been unfaithful (28xa0%).ConclusionIPV is a common experience among Nigerian rural women. Partners need education on dangers of alcohol use and its association with IPV. Different strategies are needed to prevent and reduce IPV.