Kayode T. Ijadunola

The unmet need for contraception among Nigerian women in the first year post-partum

Objective To determine the level of Unmet need for Contraception among women in the first year post-delivery in Ile-Ife, Nigeria. Methods A prospective study of 256 women attending antenatal clinic of the OAUTHC, Ile-Ife, Nigeria was carried out 9–10 months post-delivery. Using a semi-structured questionnaire, the respondents were interviewed for socio-demographic characteristics; obstetric, sexual, and contraception history were also taken. The data were analyzed using descriptive and inferential statistical methods. Results There was a high level of unmet need (59.4%) in the sample of Nigerian women despite a high level of awareness of common methods of contraception. Education and parity had no significant effect on usage of contraception (p > 0.05). No reason was given for non-usage in the largest proportion (30.3%) of the non-users. Only one-third of the respondents could correctly report the ‘at-risk’ period for getting pregnant in the post-partum period. Conclusion There is a need to study in more detail the social and cultural factors that determine contraceptive utilization before success can be achieved in closing the gap of unmet need, as it has become evident that increasing the awareness and knowledge of contraception is not enough to achieve the objectives of family-planning programs.

Assessment of andropause awareness and erectile dysfunction among married men in Ile-Ife, Nigeria.

Andropause (also known as androgen decline in aging males) has implications for the reproductive health and quality of life of older males. Very few studies have, however, been reported among the Nigerian population on andropause-related issues. This study assesses the perspective and level of awareness of married men in Ile-Ife, South-west Nigeria, of andropause. We also assessed their experience of erectile dysfunction, using a questionnaire based on the review of the International Index of Erectile Dysfunction. The study involved 355 married men, aged between 30 and 70 years. Our result shows a high level of misconception about andropause among our respondents, with 38.9% indicating that it is a myth, and another 23.6% attributing it to various causes other than being a natural aging process. We recorded a prevalence of erectile dysfunction of 43.8% (8.0% severe dysfunction and 35.8% moderate dysfunction). The prevalence of erectile dysfunction increased significantly with age, varying from 38.5% for age 31-40 years to 63.9% for the older age group of 61-70 years. The trend in prevalence of erectile dysfunction with age was significant (p < 0.05). An odds ratio of 2.82 (95% confidence interval 1.19-6.76) was recorded for the prevalence of erectile dysfunction at age 61-70 years compared with age 31-40 years. Our findings indicate a need for health education about andropause in Nigeria, and increased attention to the reproductive health concerns of males, and the older population.

Determinants of adherence to antiretroviral drugs among people living with HIV/AIDS in the Ife-Ijesa zone of Osun state Nigeria.

ABSTRACT Background The advent of antiretroviral (ARV) drugs has transformed HIV/AIDS into a chronic manageable disease and strict adherence is required for the medication to be effective. However, factors influencing adherence to ARV therapy (ART) vary from country to country. Method 120 subjects who received ARV drugs at a federal government-designated ART site located within the Obafemi Awolowo University Teaching Hospital complex, (OAUTHC), Ile-Ife, and a community-based non-governmental organisation, Living Hope Care (LIHOC), Ilesa, from February to May 2006 were serially recruited and studied. Relevant data were collected using an interviewer-administered, patient medication adherence questionnaire. Focus group discussions were also held among the subjects to further elicit qualitative information on factors influencing adherence to ART. Results The age of participants ranged from 21 to 65 years with a mean age of 40.2 + 10.3 years. Participants had been on ARV drugs for a period ranging between three and 60 months. The overall adherence rate in the study population was 44%. 66% of participants who accessed ARV drugs from LIHOC, Ilesa, had good adherence while only 14% of participants who accessed ARV drugs from OAUTHC, Ile-Ife, had good adherence. Participants with good adherence did not pay funds for the preliminary ARV eligibility investigations and they were also offered regular adherence counselling. These facilities were barely available in the group with poor adherence. Demographic factors such as age, gender and marital status did not seem to have any significant association with adherence level (p > 0.05). Conclusion The level of adherence was high in a cohort of PLWHA accessing ARV drugs in Ilesa while it was low among PLWHA receiving ART in Ife. The most important reasons for this difference were lack of funds for investigations and poor psycho-social counselling.

Provider-initiated (Opt-out) HIV testing and counselling in a group of university students in Ile-Ife Nigeria.

ABSTRACT Objectives The Provider Initiated HIV (Opt-out) Testing and Counselling model has rarely been tested in Nigeria. This study assessed its feasibility and uptake among a sample of Nigerian university undergraduate students. Methods Two hundred and fifty-two Nigerian university students were offered rapid ‘opt-out’ HIV tests. The participants were also interviewed using a self-administered questionnaire. Data were analysed using descriptive statistics. Results Two hundred and fifty-one (99.6%) students accepted to be tested and only one (0.4%) refused testing. The commonest reason given for accepting rapid ‘opt-out’ testing was the desire to find out HIV status (93.2%). Only 24 (9.5%) students had previously ever been tested for HIV; among the 228 (90.5%) respondents who had not, the commonest reasons given for not testing were lack of knowledge of where to go to (25%), fear of testing positive (24%), and perception of being unlikely to have been exposed to HIV (18%). Conclusion HIV ‘opt-out’ testing holds the prospect for rapidly increasing the coverage of HIV testing and other preventive interventions among university students in Nigeria. However, waiting time before testing and the poor disposition of medical staff to add on the burden of HIV ‘opt-out’ tests remain potential barriers to its roll-out.

Asthma in a university campus: a survey of students and staff of Obafemi Awolowo University, Ile-Ife, Nigeria

Abstract Background: Asthma continues to be an important cause of morbidity and mortality in developing countries. But, its burden among adult populations in university campuses is not well described. Method: Through a multistage cluster sampling of students and staff of the Obafemi Awolowo University, Ile-Ife, Nigeria, we obtained a representative sample, each for students and staff. We administered the European Community Respiratory Health Survey (ECRHS) screening questionnaire to all the respondents. A subgroup did a spirometry test and completed a detailed questionnaire. Asthma was considered “possible”, if a respondent provided affirmative response to symptoms of “wheezing or whistling”, “attack of shortness of breath”, “diagnosed attack of asthma” in the last 12 months or “currently taking medicines for asthma”. Results: From population of 13 750 students and 1428 staff of the university, we systematically sampled 2750 (20%) students and all the staff. Amongst these, 2372 students and 455 staff completed the screening questionnaire. The mean age (SD) of the responders was 21.9 (3.2) and 46.1 (8.9) for students and staff and most of them were men; 58.6% and 65.9%, respectively. While an estimated 2.6% (95% CI: 1.7–3.5) of students had an asthma attack in the preceding 12 months, 14.5% (95% CI: 12.5–16.5) and 25.2% (95% CI: 22.8–27.7) reported shortness of breath and nocturnal cough, respectively. The staff population reported fewer symptoms. The proportion with “possible asthma” was 18.2% (95% CI: 16.0–20.4) for students and 8.0% (95% CI: 5.4–10.7) for staff. Conclusion: The prevalence of asthma is high among students and staff of Obafemi Awolowo University, Nigeria.