O R Balogun

Sexual activity and contraceptive use among young female students of tertiary educational institutions in Ilorin, Nigeria

BACKGROUND A survey was conducted to evaluate the pattern of sexual behavior and contraceptive use among female students aged 15 to 24 years attending tertiary institutions in Ilorin, Nigeria. STUDY DESIGN A valid and reliable semistructured questionnaire was self-administered to a sampled population of 600 students aged 15 to 24 years. RESULTS Of the 600 students, 562 (93.7%) completed the questionnaire. Most (98.6%) of the respondents were unmarried, 77.6% have had sexual intercourse, 67.8% have had an unwanted pregnancy while 63.5% have had induced abortion. All the respondents were aware of contraceptives, but only 25.4% have ever used any contraceptive method. The most common sources of information about contraception among the respondents were friends/relatives (73.7%), while the fear of side effects of modern contraceptives was the most common reason (77.5%) for nonuse. CONCLUSION The fear of side effects is the main reason for low contraceptive prevalence among young female students of tertiary institutions in Ilorin. Reproductive health services should focus more on delivery of adequate and accurate information about contraceptives to improve use among young women.

Pattern of cervical dilatation among parturients in Ilorin, Nigeria.

OBJECTIVE To evaluate the pattern of cervical dilatation in live singleton pregnancies with spontaneous onset of labor and to compare any differences among nulliparas (P ara 0) and multiparas (Para >or=1). MATERIAL AND METHODS Descriptive statistics are presented for 238 consecutive labor patients with spontaneous onset, >or=37 weeks gestation, live singleton pregnancy and who had spontaneous vertex delivery at the University of Ilorin Teaching Hospital, Nigeria, from May 2004 to June 2004. Pre-labor rupture of membrane and referred cases were excluded. RESULTS The mean cervical dilatation on presentation and duration of labor before presentation in labor ward among nulliparas were 5.40 cm and 6.66 hours; and among multiparas, 6.45 cm and 5.15 hours, respectively, the overall mean being 6.12 cm and 5.63 hours, respectively. The average time spent to achieve full cervical dilatation from time of arrival in labor ward was longer in nulliparas (4.80 hours) than in multiparas (3.60 hours) (t test not significant; P> 0.05). Overall mean total length of first stage of labor was 9.36 hours, while the total length of first stage of labor was 11.03 hours and 8.53 hours for nulliparas and multiparas, respectively (difference is significant; t test P< 0.05). Significant negative correlation existed between parity and total length of first stage of labor. Mean cervical dilatation rate in labor ward (active phase) was higher in multiparas (1.83 cm/h) than in nulliparas (1.76 cm/h), but the difference was not significant (t test P> 0.05). No significant correlation existed between rate of cervical dilatation and maternal age, gestational age and fetal size. CONCLUSION It is evident from this study that higher the parity the shorter the length of first stage of labor; however, significant difference existed only in the first half of first stage of labor between nulliparas and multiparas. Mean rate of cervical dilatation was greater than the WHO-specified and Philpotts lower limit of 1 cm/h in active phase of labor.

Acceptability of Measures Aimed at Preventing Mother-to-Child Transmission of HIV among Pregnant Women

OBJECTIVE To assess the acceptability of measures aimed at preventing mother-to-child transmission of HIV among counseled and yet-to-be-counseled antenatal women in a federal medical center in Nigeria. METHODS A valid and reliable questionnaire was interviewer administered to newly booking antenatal women who were yet to be counseled about HIV/AIDS and women on an antenatal follow-up visit who had already been counseled about HIV/AIDS. RESULTS A total of 108 newly booked women and 116 women on follow-up visit responded to the questionnaire. The proportion of the counseled women who accepted HIV screening (98%) was significantly higher than the proportion of the yet-to-be-counseled women who would want to be screened (88%). Also, the proportions of the counseled women who accepted HIV screening so as to benefit from interventions like prevention of mother-to-child transmission, antiretroviral therapy and prevention of transmission to partner were significantly higher than the proportions among the yet-to-be-counseled women. The majority of the women in the study would accept antiretroviral drugs and avoidance of breastfeeding to prevent mother-to-child transmission, while only 29 (14%) respondents would accept cesarean section to prevent mother-to-child transmission. There was no statistically significant difference in the proportion of the counseled women (15%) who would accept cesarean section to prevent mother to child transmission when compared to the proportion among the yet-to-be-counseled women (11%). CONCLUSION Antenatal HIV screening is acceptable to most pregnant women attending our hospital, and while many would accept antiretroviral drugs and avoidance of breastfeeding to prevent mother-to-child transmission of HIV, there is low acceptability of elective cesarean section.

Evaluation of parturient perception and aversion before and after primary cesarean delivery in a low-resource country

To determine the perception of and aversion to cesarean delivery (CD) and their determinants before and after primary CD.

Attitudes to female genital mutilation/cutting among male adolescents in Ilorin, Nigeria.

BACKGROUND The central role of males in female reproductive health issues in patriarchal societies makes them an important group in the eradication of female genital mutilation/cutting (FGM/C). OBJECTIVE To determine knowledge about and attitudes to FGM/C among male adolescents, and their preparedness to protect their future daughters from it. METHODS A cross-sectional survey among male adolescent students in Ilorin, Nigeria. Participants completed a self-administered questionnaire after consent had been obtained from them or their parents. Statistical analysis was with SPSS version 20.0 (IBM, USA). A p-value of <0.05 was taken as significant. RESULTS Of 1 536 male adolescents (mean age 15.09 (standard deviation 1.84) years, range 14 - 19), 1 184 (77.1%) were aware of FGM/C, 514 (33.5%) supported female circumcision, 362 (23.6%) would circumcise their future daughters, 420 (27.3%) were of the opinion that FGM/C had benefits, mostly as a necessity for womanhood (109, 7.1%), and 627 (40.8%) perceived it as wickedness against females; 546 (35.5%) were aware of efforts to eradicate FGM/C, and 42.2% recommended education as the most important intervention to achieve this. CONCLUSION Education and involvement in advocacy may transform male adolescents into agents for eradication of FGM/C.

Haematological and biochemical effects of etonogestrel subdermal implant (Implanon) in Ilorin Nigeria

OBJECTIVES To evaluate the effect of etonogestrel subdermal implant (Implanon) on haematological and biochemical parameters of its users. METHODOLOGY A prospective observational study among healthy women using Implanon for contraception. The study site was the family planning clinic of the University of Ilorin Teaching Hospital, Ilorin, Nigeria. Informed consent was obtained and participants were followed up for three years. Follow up parameters were haematological and biochemical evaluation at insertion (baseline), first and third years post-insertion. Statistical analysis was with SPSS-version 20.0; p value <0.05 was significant. RESULTS 124 participants of age 20-44 years were included in the study. During the period of study, a progressive increase in the weight as well as in the level of alanine transaminase and systolic blood pressure was recorded. As compared to the baseline values, statistically significant difference in the mean values of systolic blood pressure (p<0.01), alanine transaminase (p<0.01) and weight (p=0.001) were recorded at the first year. Packed Cell Volume (p=0.001), weight (p=0.001), alanine transaminase (p=0.001) and alkaline phosphatase (p<0.05) were significant at the third year. Between the first and third year post-insertion, there was statistically significant difference in Packed Cell Volume (p=0.001), urea (p<0.05), aspartate (p=0.001) and alanine transaminase (p=0.001) and weight (p=0.001). However, there were no clinically detectable abnormalities or pregnancy during the study period. CONCLUSION Haematological and biochemical parameters change with Implanon use but they were not significant to cause clinical sequelae. Implanon remains a safe long term contraceptive.