John Sotunsa

Impact of health education intervention on knowledge and perception of cervical cancer and cervical screening uptake among adult women in rural communities in Nigeria

BackgroundCervical cancer is a disease of public health importance affecting many women and contributing to avoidably high levels of cancer deaths in Nigeria. In spite of the relative ease of prevention, the incidence is on the increase. This study aimed to determine the effect of health education on the awareness, knowledge and perception of cervical cancer and screening among women in rural Nigerian communities.MethodsThe study design was quasi-experimental. The study was carried out among adult women in Odogbolu (intervention) and Ikenne (control) local government areas (LGA) of Ogun state. Three hundred and fifty (350) women were selected per group by multistage random sampling technique. Data was collected by semi structured interviews with the aid of questionnaire. The intervention consisted of structured health education based on a movie.ResultThe intervention raised the level of awareness of cervical cancer and screening to 100% (p < 0.0001). The proportion of women with very good knowledge of cervical cancer and screening rose from 2% to 70.5% (χ2 = 503.7, p < 0.0001) while the proportion of those with good perception rose from 5.1% to 95.1% (p < 0.0001). The mean knowledge and mean perception scores were also increased (p < 0.0001). There was increase in the proportion of women who had undertaken cervical screening from 4.3% to 8.3% (p = 0.038). The major reason stated by the women for not having had cervical screening done was lack of awareness about cervical cancer and screening. There was statistically significant difference between the intervention and control groups concerning their knowledge attitude and practice towards cervical and screening (p < 0.05) after the intervention.ConclusionMultiple media health education based on a movie is effective in creating awareness for and improving the knowledge and perception of adult women about cervical cancer and screening. It also improves the uptake of cervical cancer screening. The creation of awareness is very crucial to the success of a cervical cancer prevention programme.

Community health workers' knowledge and practice in relation to pre-eclampsia in Ogun State, Nigeria: an essential bridge to maternal survival.

BackgroundPre-eclampsia is a leading cause of maternal and fetal morbidity and mortality worldwide. Early detection and treatment have been instrumental in reducing case fatality in high-income countries. To achieve this in a low-income country, like Nigeria, community health workers who man primary health centres must have adequate knowledge and skills to identify and provide emergency care for women with pre-eclampsia.This study aimed to determine community health workers’ knowledge and practice in the identification and treatment of pre-eclampsia, as they are essential providers of maternal care services in Nigeria.MethodsThis study was part of a multi-country evaluation of community treatment of pre-eclampsia. Qualitative data were obtained from four Local Government Areas of Ogun State, in south western Nigeria by focus group discussions (N = 15) and in-depth interviews (N = 19). Participants included a variety of community-based health care providers - traditional birth attendants, community health extension workers, nurses and midwives, chief nursing officers, medical officers – and health administrators. Data were transcribed and validated with field notes and analysed with NVivo 10.0.ResultsCommunity-based health care providers proved to be aware that pre-eclampsia was due to the development of hypertension and proteinuria in pregnant women. They had a good understanding of the features of the condition and were capable of identifying women at risk, initiating care, and referring women with this condition. However, some were not comfortable managing the condition because of the limitation in their ‘Standing Order’; these guidelines do not explicitly authorize community health extension workers to treat pre-eclampsia in the community.ConclusionCommunity-based health care providers were capable of identifying and initiating appropriate care for women with pre-eclampsia. These competencies combined with training and equipment availability could improve maternal health in the rural areas. There is a need for regular training and retraining to enable successful task-sharing with these cadres.Trial registrationNCT01911494.

Elimination of Mother-To-Child Transmission of HIV in Nigeria: The Roles, Preparedness and Determinants of Successful Involvement of Traditional Birth Attendants

Background: Prevention of mother to child transmission of HIV plays a major role in reducing the number of children being infected with HIV. This study provides baseline information about the knowledge, practice and factors that affect PMTCT service provision by traditional birth attendants. Methods: A cross-sectional study of 142 traditional birth attendants in Ogun State, Nigeria carried out between January and March, 2014. Sample selection was by two-staged probability sampling technique. Data collection employed structured pre-tested questionnaires. Data were analysed using SPSS software for Windows (version 18). Uni-variate, bi-variate and multivariate analyses were done. Results: Participants were universally aware of HIV. Participants’ ability to correctly identify temporal mode of MTCT of HIV varied from 69.0% for ante-partum; and 76.1% during labour and delivery to 60.6% during breastfeeding. Most of them (81.7%) knew that MTCT of HIV is preventable. Most of them knew that knowledge of HIV status (94.4%); and HCT (98.6%) were important for pregnant women. The mean score for knowledge of MTCT and PMTCT of HIV was 16.89 ± 1.89. Participants with secondary education or more (AOR = 3.020, 95%, CI = 1.362-6.697) were likely to know more about MTCT and PMTCT of HIV. Majority (88.7%) of the TBAs always offer HCT to pregnant women; 122 (85.9%) always refer HIV-positive women to treatment centres; and 126 (88.7%) always provide referral support for patients. The mean score for PMTCT care practice for the participants was high (45.85 ± 9.48). Conclusion: TBAs have a role to play in the e-MTCT of HIV in Nigeria and are poised to do so. They have some knowledge and good practices as it relates to MTCT and PMTCT of HIV. Some misconceptions and bad practices exist especially as it relates to infant feeding practices. These need to be comprehensively addressed.

The Determinants of Sexual Risk Behavior for HIV/AIDS among University Students in Ilishan, Nigeria

Aims: HIV in sub-Saharan Africa is closely linked to the sexual behavior of the population. The knowledge of the impact of socio- demographic and an increasing religious movement, on risk behavior for HIV/AIDS among University students in Nigeria and the rest of the sub-Saharan Africa is uncertain and even contradictory. The aim of this study was to investigate the role of socio-demographic and religious factors in determining risk behavior for HIV/AIDS among University students in Ilishan, Nigeria. Methodology: This is a cross-sectional study of 1225 university students selected by probability sampling method. Data were collected using an expert validated questionnaire. Data were collected on dependent variables i.e. being sexually active, having multiple sexual partners and inconsistent condom use, and the independent variables that included demographic, social and religious factors.

Demographic factors related to male involvement in reproductive health care services in Nigeria

Objectives Men play a well-recognised role in reproductive health care. They are pertinent to the achievement of female reproductive health. This study assessed male involvement in reproductive health issues in Nigeria and identified relevant factors. Methods This was a cross-sectional study of 1530 married men aged 25 to 45 years selected by a multi-stage sampling procedure. Bivariate and logistic regression analyses were performed, with male involvement in reproductive health care as the dependent variable. Results The mean age of the respondents was 38.64 (± 5 SD) years. Although 65.9% of the respondents discussed reproductive health issues with their wife, only 39.6% accompanied them during visits to clinics. Less than one-third (30.9%) of the respondents were involved in reproductive health care. Male involvement in reproductive health care is predicted by having completed at least secondary education (OR 4.337; p = 0.007), having one or no living child (OR 2.002; p = 0.001), and approval of family planning (OR 2.637; p = 0.000). Conclusions Male involvement in reproductive health care is predicted by level of education, number of living children and approval of family planning. There is a need to focus on the identified factors in order to strengthen and increase male participation in reproductive health care. 摘 要 目的 男性在生殖保健过程中起着公认的重要作用，他们和女性生殖健康取得的成就有关。本研究对尼日利亚男性参与生殖保健的相关问题进行评估并确定其相关因素。 方法本研究选择横断面研究，通过多阶抽样选择25-45岁已婚男性1530例，男性是否参与生殖保健作为因变量，应用二元回归和logistic回归分析。 结果 受访者平均年龄38.64±5岁，尽管65.9%的受访者和他们的妻子讨论生殖健康问题，仅仅有39.6%的人陪伴他们的妻子去诊所。不到1/3（30.9%）的受访者参与生殖保健。男性是否参与生殖保健可以通过以下因素预测：至少完成中学教育(OR4.337; p=0.007)、有一个或者没有孩子(OR2.002; p=0.001)以及赞成计划生育(OR2.637; p=0.000)。 结论 男性是否参与生殖保健可以通过受教育程度、子女数目和赞成计划生育等因素预测。需要关注这些已知的因素以强化和增加男性对于生殖保健的参与。

The Effect of Training on Traditional Birth Attendants' PMTCT Related Knowledge and Care Practices in Nigeria

Introduction: As much as 60% of children born in Nigeria are delivered by unskilled traditional birth attendants. It imperative for traditional birth attendants and similar cadre of health care providers in resource-limited settings to be knowledgeable and have the ability to deploy evidence based practices in the prevention of mother to child transmission of HIV if the goal of an AIDS free generation will be achieved. The successful linkage of evidence with practice in sub-Saharan Africa and other resource limited settings will translate into the reduction of MTCT of HIV as has been achieved in other parts of the world. Methods: A cross-sectional survey of 142 traditional birth attendants. The research was based on diffusion of innovation theory. Practices related to prevention of mother to child transmission of HIV were evaluated relative to national guidelines. Linear mixed modelling was used to evaluate the association between PMTCT practices and training on prevention of mother to child transmission of HIV. Results: Most traditional birth attendants were knowledgeable and had good practices relating to prevention of mother to child transmission of HIV. However, significant gaps in HIV exposed infant care; infant feeding practices and harmful traditional practices exist. Conclusions: Traditional birth attendants have a role in the prevention of mother to child transmission of HIV. Evidence-based practices that are related to maternal HIV transmission are being taken from research and policy into patient care domains; though there are some gaps in vital practices. Innovative strategic interventions are very essential to enhance participation of TBAs in the PMTCT of HIV.

Correlation between Body mass index, Waist Hip ratio, blood sugar levels and blood pressure in apparently healthy adult Nigerians

Background: Obesity is a global epidemic and is on the rise. Obesity is defined as a body mass index (BMI) which is equal to or more than 30kg/m 2 . It is one of the modifiable risk factors of type 2 diabetes. This study was undertaken to assess the relationship between BMI, WHR, RBS and BP. Method: This cross-sectional study included 776 apparently healthy adult individuals who met the inclusion criteria. Random blood samples were collected to measure RBS using glucometers. Data on BMI, waist and hip circumference and blood pressure were collected from apparently healthy individuals. Result: The mean BMI was in the overweight range, 25.49±5.15 kg/m 2 and was higher in females. About two-thirds (62.8%) of the participants had abnormally elevated WHR. RBS, SBP and DBP increased significantly with increasing BMI status (p=0.000, p=0.000 and p=0.007 respectively) and were significantly higher with abnormally elevated WHR than in participants with normal WHR (p=0.000, p=0.000 and p=0.000 respectively). However, overweight individuals tended to have a higher RBS than the obese. There was a significant correlation between BMI and RBS (0.083, p=0.020), SBP (0.206, p=0.000) and DBP (0.152, p=0.000). There was a slightly stronger correlation between WHR and RBS (0.093, p=0.009), SBP (0.273, p=0.000) and DBP (0.217, p=0.000). Conclusion: BMI and WHR are positively correlated with RBS and blood pressure in Nigeria. The Nigerian population is therefore at risk of Obesity and its related conditions (hyperglycemia and hypertension).

Predictors of Sexual Abstinence and Attitude towards PLHIV among Undergraduate Students in a Privately Owned University in South West Nigeria.

Background: Universities in the high prevalence nations of sub-Saharan Africa have significant proportions of their students and staff being infected with HIV. The prevalence of risk behaviors for HIV/AIDS continues to rise especially among university students. The objective of this study is to identify predictors of sexual abstinence and attitude towards PLHIV among Babcock University students. Methods: A cross-sectional study of 1225 undergraduates selected by multistage sampling technique was conducted in a privately University in Nigeria. Data were collected using structured self-administered questionnaire. Results: All the participants were aware of HIV/AIDS. About one-quarter (24.1%) of the students Original Research Article Abiodun et al.; BJMMR, 8(9): 790-801, 2015; Article no.BJMMR.2015.507 791 had ever had sex. Knowledge about HIV/AIDS was very high as 87.7% of them had very good knowledge. Between 74.1% and 89.8% of the students demonstrated correct attitude towards the various attitude questions about PLHIV. Students who were less than 21 years (AOR=1.64), do not take alcohol (AOR=1.94), those with good knowledge of HIV/AIDS (AOR=2.15) were more likely to abstain from sex than their counterparts respectively. Male participants (AOR=0.64) were less likely to abstain from sex than females. The likelihood of having poor attitude towards PLHIV was less in those with good knowledge (AOR=0.16) and more in those with self-reported poor knowledge (AOR=2.97) than their respective counterparts. Conclusions: This study has identified the factors that promote sexual abstinence and reduce HIV-related stigmatization among young people. Many factors are involved. Hence, an integrated multi-sectoral and multidirectional approach is recommended for the provision of relevant HIV/AIDS knowledge, comprehensive abstinence sexuality education to young persons.

Psychometric Properties of Alcohol Smoking and Substance Involvement Screening Test (Assist V3.0) Among University Students

Psychometric Properties of Alcohol Smoking and Substance Involvement Screening Test (Assist V3.0) Among University Students Background: Urine drug test was in use among the undergraduates in the study area for 4 years. The World Health Organization’s Alcohol Smoking and Substance Involvement Screening Test (ASSIST) was introduced recently. This study aimed to determine the reliability of the self-report and its validity against urine drug test. Methods: This study of diagnostic accuracy was conducted among students of Babcock University, Nigeria, in 2013. Each student had urine drug test and interview with the use Alcohol Smoking and Substance Involvement Screening Test (ASSIST) on the same day. The laboratory officers and the interviewers were blind to the results of each other. Results: The 2797 participants were mostly 18-20 years (61.2%) and females (65.1%), Urine of 0.1% tested positive to cannabis and Methamphetamine, 0.4% to Opiates. The three-month selfreport gave the prevalence rates of Amphetamine Type Stimulants, Opioids, Diazepam, Cannabis and cocaine at 1.2%, 2.6%, 1.4%, 1.0%, and 0.3% respectively. Against the urine drug test, ASSIST had low sensitivity and high specificity. Its diagnostic accuracy was greater than 95%. Eleven domains of ASSIST had internal correlation coefficients of greater than 0.7. Conclusions: The ASSIST version 3 has acceptable psychometric properties and is valid for use among university students.