Olumuyiwa O. Odusanya

Breast Cancer Knowledge, Attitudes and Practice among Nurses in Lagos, Nigeria

A cross-sectional survey was conducted among nurses working in a general hospital in Lagos to determine their knowledge, attitude and practice regarding breast cancer. A self-administered questionnaire was used to investigate knowledge of symptoms, methods of diagnosis and use of cancer screening methods. Two hundred and four nurses out of 280 participated in the study (73% response rate). Knowledge about symptoms, methods of diagnosis and self-breast examination was generally very good. However, only 30% had had a clinical breast examination and 8% a mammogram within the past three years. Use of cancer screening methods was significantly associated with knowledge of the subject (p = 0.03). Twenty-eight percent did not know how to estimate the risk of cancer and 61% believed they were not at risk. Nurses possess adequate knowledge about breast cancer but they need more information on cancer risk estimation.A cross-sectional survey was conducted among nurses working in a general hospital in Lagos to determine their knowledge, attitude and practice regarding breast cancer. A self-administered questionnaire was used to investigate knowledge of symptoms, methods of diagnosis and use of cancer screening methods. Two hundred and four nurses out of 280 participated in the study (73% response rate). Knowledge about symptoms, methods of diagnosis and self-breast examination was generally very good. However, only 30% had had a clinical breast examination and 8% a mammogram within the past three years. Use of cancer screening methods was significantly associated with knowledge of the subject (p = 0.03). Twenty-eight percent did not know how to estimate the risk of cancer and 61% believed they were not at risk. Nurses possess adequate knowledge about breast cancer but they need more information on cancer risk estimation.

Knowledge of risk factors, beliefs and practices of female healthcare professionals towards breast cancer in a tertiary institution in Lagos, Nigeria

BackgroundBreast cancer is the leading female malignancy in Nigeria. Screening for early detection has led to reduction in mortality from the disease. It is known that attitudes of physicians and motivation by community nurses influence uptake of screening methods by women. This study aims to investigate knowledge of breast cancer risk factors, beliefs about treatment and practice of screening methods among a cohort of female healthcare professionals in Lagos, Nigeria.MethodsA cross-sectional study was conducted using a self-administered questionnaire to assess the knowledge of breast cancer risk factors, beliefs about treatment and practice of screening methods among 207 female doctors, nurses and other healthcare professionals working in a university teaching hospital in Lagos, Nigeria. Stratified random sampling method was employed. Chi square test, analysis of variance and Mantel-Haenszel test were performed in data analysis using SPSS v10.0 and Epi Info version 6 statistical packages.ResultsFemale doctors obtained a mean knowledge score of 74% and were the only professional group that had satisfactory knowledge of risk factors. Majority (86%) believed that early breast cancer is curable while half of participants believed that prayer can make breast cancer disappear from the affected breast. Eighty three percent practice breast self-examination (BSE) once a month and only 8% have ever had a mammogram. Age, knowledge of risk factors, profession and beliefs were not significantly associated with rate of BSE in this study.ConclusionResults from this study suggest the need for continuing medical education programmes aimed at improving knowledge of breast cancer among female healthcare providers other than doctors.

Primary vaccination with the 10-valent pneumococcal non-typeable Haemophilus influenzae protein D conjugate vaccine (PHiD-CV) in infants in Mali and Nigeria: a randomized controlled trial

BackgroundPneumonia is still the leading cause of death among children in Africa, and pneumococcal serotypes 1 and 5 are frequently isolated from African children with invasive pneumococcal disease below the age of 5 years. The immunogenicity, safety and reactogenicity of 3-dose primary vaccination with the 10-valent pneumococcal non-typeable Haemophilus influenzae protein D conjugate vaccine (PHiD-CV) were evaluated in infants in Mali and Nigeria.MethodsIn an open, randomized, controlled study, 357 infants received DTPw-HBV/Hib and OPV primary vaccination with (PHiD-CV group) or without (control group) PHiD-CV co-administration at 6, 10 and 14 weeks of age. Pneumococcal antibody responses and opsonophagocytic activity (OPA) were measured and adverse events (AEs) recorded.ResultsOne month post-dose 3, ≥ 97.2% of PHiD-CV-vaccinated infants had an antibody concentration ≥ 0.2 μg/mL for each vaccine pneumococcal serotype except for 6B (82.0%) and 23F (87.6%) versus < 10% in the control group except for serotypes 14 (35.7%) and 19F (22.5%). For each vaccine serotype, ≥ 93.3% of PHiD-CV recipients had an OPA titre ≥ 8, except for serotypes 1 (87.6%) and 6B (85.4%), compared to < 10% in the control group, except for serotypes 7F (42.9%), 9V (24.1%) and 14 (24.5%). Anti-protein D geometric mean antibody concentrations were 3791.8 and 85.4 EL.U/mL in the PHiD-CV and control groups, respectively. Overall incidences of solicited and unsolicited AEs were similar between groups.ConclusionsIn sub-Saharan African infants, PHiD-CV was immunogenic for all vaccine pneumococcal serotypes and protein D. Vaccine tolerability was generally comparable between the PHiD-CV and control groups.Trial RegistrationClinicalTrials.gov identifier: NCT00678301.

Survival from adult tetanus in Lagos, Nigeria

A longitudinal recruitment of adult tetanus patients to determine the survival rate of adult tetanus patients was conducted at the Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria. One hundred and sixty-four patients were admitted and forty-nine (30%) survived. The only significant determinant of survival was young age (P = 0.017).

Five-year post vaccination efficacy of hepatitis B vaccine in rural Nigeria

Hepatitis B (HB) is an important public health problem affecting millions of people globally and is endemic in Nigeria. The objective of this study was to determine the effectiveness of the HB vaccine five to seven years post-introduction within a rural community in Nigeria. The study design was cross-sectional. Eligible children were either vaccinated subjects who had received at least two doses of HB vaccine or unvaccinated subjects (controls) who had not received HB vaccine. Following informed consent obtained from mothers/care givers, data was obtained using an interviewer-administered questionnaire. Venous blood was obtained to measure HB markers including hepatitis B surface antigen (HBsAg), and antibodies to the core (anti-HBc) and antibody to the hepatitis B surface (anti-HBs) antigens. Eight hundred and twenty-two subjects were eligible for analysis consisting of 449 vaccinated and 373 controls. The prevalence of anti-HBc was 43.2% in unvaccinated children compared to 10.5% in vaccinated children (p < 0.001). The rate of HBsAg was 11.8% in the unvaccinated group and 2% in the vaccinated group (p < 0.001). The vaccine effectiveness against anti-HBc was 84.6% (95% confidence interval 77.8, 89.3%) and the effectiveness against infection was 84.7% (95% confidence interval 68.2, 92.6%). Sixty-one percent of vaccinated subjects had protective antibodies ≥10 EIU/ml compared to 18% of controls (p < 0.001) and the geometric mean titers (GMT) were 19.96 and 7.28 EIU/ml respectively (p < 0.001). Vaccinated subjects were protected at least for five to seven years following HB vaccination.

Safety and immunogenicity of 10-valent pneumococcal nontypeable Haemophilus influenzae protein D conjugate vaccine (PHiD-CV) in Nigerian children: Booster dose and 2-dose catch-up regimens in the second year of life.

In a previous study, 3-dose primary vaccination of Nigerian infants with the 10-valent pneumococcal nontypeable Haemophilus influenzae protein D conjugate vaccine (PHiD-CV) was immunogenic for vaccine pneumococcal serotypes, with comparable tolerability between PHiD-CV and control groups. In an open-label study (ClinicalTrials.gov, NCT01153893), 68 primed children received a PHiD-CV booster dose co-administered with a diphtheria-tetanus-acellular pertussis (DTPa) booster dose at 15–21 months and 36 children unprimed for pneumococcal vaccination received two PHiD-CV catch-up doses (first dose co-administered with DTPa booster dose) at 15–21 and 17–23 months. Adverse events were recorded and immune responses were measured before and one month after vaccination. In both groups, pain was the most frequent solicited local symptom and fever was the most frequent solicited general symptom after the booster dose and each catch-up dose. Few grade 3 solicited symptoms and no vaccine-related serious adverse events were reported. After booster vaccination, for each vaccine serotype, at least 98.5% of children had an antibody concentration ≥0.2 µg/ml and at least 94.0% had an opsonophagocytic activity (OPA) titer ≥8. After 2-dose catch-up, for each vaccine serotype, at least 97.1% had an antibody concentration ≥0.2 µg/ml, except for serotypes 6B (82.9%) and 23F (88.6%), and at least 91.4% had an OPA titer ≥8, except for serotypes 6B (77.4%) and 19F (85.3%). PHiD-CV induced antibody responses against protein D in both groups. In conclusion, PHiD-CV administered to Nigerian toddlers as a booster dose or 2-dose catch-up was well tolerated and immunogenic for vaccine pneumococcal serotypes and protein D.

Neonatal Jaundice: Knowledge, Attitude and practices of mothers in Mosan-Okunola community, Lagos, Nigeria

Background: A community-based survey was conducted amongst mothers aged 15–49 years living in Mosan-Okunola, Lagos, Nigeria to determine the knowledge of, attitudes to, preventive and treatment practices towards neonatal jaundice (NNJ). Materials and Methods: The mothers were selected using a multi-stage sampling technique. A pre-tested interviewer-administered structured questionnaire was used to obtain data. The knowledge of the mothers was scored and scores lower than 50% were graded as poor, 50–74% as fair and ≥75% as good. The practice was also categorised as appropriate if one correct option was identified and was categorised as inappropriate where an incorrect option(s) was identified singly or in combination with a correct option. Results: Three hundred and fifty-eight mothers were recruited. The mean age was 34.8 ± 9.05 years. Two hundred and seventy (75.4%) mothers had ever heard about the condition. Two hundred and forty-seven (91.4%) mothers correctly identified the condition and infection was the only most common known cause (47%). Only 34% of the mothers knew that NNJ could cause brain damage, and 40% identified refusal of feeds as a danger sign. Up to 64% of the mothers believed attending antenatal care could prevent the condition, and 58% were of the opinion that exposing babies to sunlight could prevent the condition. Sixty-eight percent (68.9%) of the mothers had a poor level of knowledge. Age and educational qualification did not show any statistically significant relationship with knowledge about NNJ (P < 0.05) but increasing maternal age had a significant association with an appropriate treatment practice (P < 0.05), the association was negative (r = −0.32). Conclusion: Knowledge about NNJ was low in this community and ineffective preventive practices were utilised. Efforts should be made to increase it, and health workers should play a leading role.

Profile and outcome of patients with post-neonatal tetanus in a tertiary centre in south west Nigeria: any remarkable reduction in the scourge?

Introduction The incidence of tetanus has remained unacceptably high in developing countries. We aimed to describe the profile and outcome of children with tetanus admitted at the Lagos State University Teaching Hospital (LASUTH), Ikeja. Methods A prospective and cross-sectional study of children aged 1 month to 12 years of age admitted with clinical diagnosis of tetanus, between January 2011 and December 2013, at the Paediatric department of LASUTH. The age, sex, presenting complaint, immunization status, portal of entry, socio-economic class, complications, duration of admission and outcome of the subjects were analyzed using Microsoft Excel supplemented with Statistical Package for Social Sciences (SPSS) version 17.0. Level of significance set at p< 0.05. Results A total of 49 subject participated in the study. Male: Female ratio was 1.7: 1.0. mean age ± SD of 6.5± 3.2 years. Only 24.5% of the subjects were fully immunized, lower limb injury was the most common portal of entry (34.7%). Majority (79.6) were of the middle and lower social classes. Most of the subjects (67.3%) presented with generalised spasm. Only 1 patient (2.0%) did not have trismus. Case fatality rate was 4.1%. Conclusion Tetanus is still prevalent among children in our environment. It is commoner among those with no immunization or incomplete immunization, commoner in those in the middle and lower social class. Lower limb injury was the most common portal of entry. Trismus was a common presenting feature. There is a need to develop programmes with will help improve compliance to immunization.

Youth friendly health services in a rural community of Lagos, Nigeria: are the youths receptive?

Abstract Background: Globally, the youths constitute a major segment of most societies particularly in developing countries. This study was undertaken to assess the perception and practices related to youth friendly health services (YFHS) by in-school adolescents in a rural community of Lagos, Nigeria. Methods: A descriptive cross-sectional survey was conducted on 400 proportionately selected consenting respondents from the senior classes of the three secondary schools in Agbowa community. A pre-tested interviewer-administered questionnaire was used for data collection and analysis was done with the aid of statistical software. Results: Most of the respondents were in the age range of 12–15 years with mean age being 15.33±1.54 years. About half (46.8%) of the respondents correctly described adolescents as persons between the ages of 10 and 19 years. The majority (83.2%) of the respondents first heard about the Youth Friendly Health facilities from parents, guardians and friends. However, only few of the respondents had ever visited a Youth Friendly Center. A good location, convenient hours and comfortable surroundings were the most appealing aspects of YFHS. The provision of a seminar room and educational materials (60.8% and 70.8%, respectively) are important to the respondents. Reproductive health (56.8%) was the most preferred health education topic chosen by the respondents. Conclusion: Sensitization of the youths in the Agbowa community about youth friendly health services and provision of such services would be useful in reducing risky practices and improving their health.

Caregivers of Children with Congenital Heart Disease: Does Socioeconomic Class Have Any Effect on Their Perceptions?

BACKGROUND Studies from other parts of the world have documented knowledge gaps in parents of children with congenital heart disease (CHD). The authors are not aware of any study in the Nigerian population assessing the effect of socioeconomic class on the perceptions of caregivers of children with CHD. OBJECTIVE The study aimed to evaluate the effect of socioeconomic class on the perceptions of caregivers of children with CHD. METHODS A descriptive and cross-sectional questionnaire survey was conducted in a tertiary pediatric cardiac center involving 300 caregivers of children with CHD, recruited at the outpatient clinic from April 2008 to March 2012. RESULTS Age range of the respondents was 16 to 72 years with a mean of 34.7 ± 8.1 years. Forty percent (119) of the caregivers had not heard about CHD; those in the upper socioeconomic class had better awareness (P = .02). Ninety percent of all the respondents knew that the cause of CHD is unknown. Only seven of the respondents (2.3%) had a good knowledge of the indicators, while 9.6% had a fair knowledge, almost 60% of the respondent had a poor knowledge, and up to 30% had no knowledge of the pointers. Nearly one-fifth (19.3%) of the respondents were not aware of any treatment options for children with CHD. Only 12.7% of the respondents knew the best mode of treatment, and only 43% of the respondents believed CHD could be prevented. Further analysis revealed that there was no statistically significant difference between the various socioeconomic classes with regard to knowledge of the indicators of CHD, awareness of the best mode of treatment, and perception of preventability (P = .06, .74, and .13, respectively). CONCLUSION More parents in the upper socioeconomic class had heard about CHD. However, most parents of children with CHD had poor knowledge of CHD, its indicators, its best mode of treatment, and its preventability, irrespective of their socioeconomic class. Our findings suggest an urgent need to develop an educational program to promote better understanding of CHD among caregivers.