Peace Ibo Opara

Morbidity and mortality amongst infants of diabetic mothers admitted into a special care baby unit in Port Harcourt, Nigeria

BackgroundInfants born to diabetic women have certain distinctive characteristics, including large size and high morbidity risks. The neonatal mortality rate is over five times that of infants of non diabetic mothers and is higher at all gestational ages and birth weight for gestational age (GA) categories.The study aimed to determine morbidity and mortality pattern amongst infants of diabetic mothers (IDMS) admitted into the Special Care Baby Unit of University of Port Harcourt Teaching Hospital.MethodsThis was a study of prevalence of morbidity and mortality among IDMs carried out prospectively over a two year period. All IDMs (pregestational and gestational) admitted into the Unit within the period were recruited into the study.Data on delivery mode, GA, birth weight, other associated morbidities, investigation results, treatment, duration of hospital stay and outcome were collated and compared with those of infants of non diabetic mothers matched for GA and birth weight admitted within the same period. Maternal data were reviewed retrospectively. Data were analyzed using SPSS 16.0.ResultsSixty percent of the IDMs were born to mothers with gestational diabetes, while 40% were born to mothers with pregestational DM. 38 (74.3%) were born by Caesarian section (CS), of which 20 (52.6%) were by emergency CS. There was no significant difference in emergency CS rates, when compared with controls, but non-IDMs were more likely to be delivered vaginally. The mean GA of IDMs was 37.84 weeks ± 1.88. 29 (61.7%) of them were macrosomic. The commonest morbidities were Hypoglycemia (significantly higher in IDMs than non-IDMs) and hyperbilirubinaemia in 30 (63.8%) and 26 (57.4%) respectively.There was no difference in morbidity pattern between infants of pre- gestational and gestational diabetic mothers. Mortality rate was not significantly higher in IDMsConclusionsThe incidence of macrosomia in IDMs was high but high rates of emergency CS was not peculiar to them. Hypoglycaemia and hyperbilirubinaemia were the commonest morbidities in IDMs.Referring women with unstable metabolic control to specialized centers improves pre- and post- natal outcomes. Maternal-Infant centers for management of diabetes in pregnancy are advocated on a national scale to reduce associated morbidity and mortality

Prevalence and determinants of cigarette smoking among adolescents in secondary schools in Port Harcourt, Southern Nigeria.

Abstract Background: Cigarette smoking remains a major preventable public health problem associated with premature deaths worldwide. Adolescence is a unique developmental stage between childhood and adulthood. Smoking is a lifestyle habit acquired during adolescence and into adulthood, with its associated morbidity and mortality. It is therefore important to determine the factors associated with cigarette smoking in these adolescents in order to institute preventive measures and health policies to protect these adolescents early. Objective: This study aims to determine the prevalence of smoking, factors associated with smoking, and knowledge of the harmful effects of smoking in these adolescents. Methods: A cross-sectional study of 1120 adolescents aged 10–19 years selected from 10 secondary schools in Port Harcourt was conducted using a multistage sampling technique. The Global Youth Tobacco Survey (GYTS) core questionnaire was used to collect data from the subjects. A smoker was defined as one who had ever smoked a cigarette or who had one or two puffs, while a current smoker was defined as one who had taken a puff or smoked cigarettes in the last 30 days preceding the day of the questionnaire’s completion. Results: Eighty subjects (7.1%) were smokers. This was significantly (p=<0.001) higher in males (9.7%) than in females (4%). Thirty seven (3.3%) subjects were current smokers. The mean age at which smoking was initiated was 12.47±3.0 years. Twenty six (32.5%) of the smokers reported that they were initiated into cigarette smoking by their friends, 36 (45%) just wanted to experiment, 7 (8.8%) were influenced by media advertisements while 5 (6.3%) were due to parental exposure. Parental history of smoking and poor knowledge of cancer of the lungs as a harmful effect of smoking, was significantly (p=<0.05) associated with cigarette smoking. Conclusion: The prevalence of smoking in adolescents in Port Harcourt is high and is associated with parental smoking and poor knowledge of cancer of the lungs as a harmful effect. We recommend that adolescent health education with an emphasis on the harmful effects of smoking be included in the curriculum of all secondary schools.

Prevalence of bullying in secondary schools in Port Harcourt

Abstract Background: School bullying is a global problem involving a high proportion of students worldwide. However, its prevalence and types in secondary schools in Port Harcourt is not yet known. Objective: This study aimed to determine the prevalence and types of bullying in secondary schools in Port Harcourt. Subjects: A total of 1160 students from six secondary schools in Port Harcourt comprised the sample. Materials and methods: This was a cross-sectional school-based study conducted in Port Harcourt in March 2014. Two mixed schools, two all-boys schools, and two all-girls schools were selected using purposive sampling technique. Stratified random sampling technique, by class strata (senior secondary 1, 2 and 3) was used to select 1160 students from the six schools. A 22-item self-administered questionnaire adapted from a previous study was modified and used in this study. The questions covered the prevalence, type of bullying, and socio-demographic data. Data were analyzed using SPSS version 20 (IBM SPSS Incorporated, Chicago, IL, USA). Results: About 82.2% reported being victims of bullying, whereas 64.9% reported being bullies. About 9.7% and 11.8% were neither bullies nor bullied, respectively. Bullying was significantly higher in the all-boys (90.8%) and all-girls (82.9%) schools than in the mixed schools (73.5%), p=0.000. More males were victims (53.4%) and bullies (53.3%) but more females (55.4%) were bully-victims. The most common (57.5%) type of bullying was physical bullying. Conclusion: The rate of bullying was found to be very high in secondary schools in Port Harcourt.

Sexual Behaviours of Secondary School Students in Port Harcourt

Background: Sexual behaviours of adolescents are currently receiving global attention because a high proportion of new HIV and other sexually transmitted infections’ diagnosis are among young people. This study aimed to assess the sexual behaviours of secondary school students in Port Harcourt. Methods: This is a school-based cross sectional descriptive study, carried out in six public secondary schools in Port Harcourt Metropolis in Rivers State, Nigeria in February 2014. A structured pre-tested, self-administered questionnaire was distributed to 1047 senior secondary 1 to 3 students selected through multistage sampling technique. Information sought included sociodemographics, if they have had sexual intercourse, age at first sex, involvement in sexual intercourse in the last 3 months before the survey, condom use and number of sex partners. Statistical analysis was performed using SPSS version 20.0 statistical software. Univariate and multiple logistic regression analysis were done to describe socio-demographics and sexual behaviours of study participants and to identify independently associated factors. Original Research Article Alex-Hart et al.; BJMMR, 6(3): 325-334, 2015; Article no.BJMMR.2015.208 326 Results: One thousand and forty seven students participated in the study; mean age 16.19±1.64 SD. Five hundred and thirty seven (51.3%) females and 510 (48.7%) males, male: female ratio was 0.9: 1. Four hundred and forty nine (42.9%) students reported having had sex at least once in their life time. Mean age at first sexual intercourse was 13.37±3.66SD. More females reported having sex compared to the males (χ=7.357, P=.007). The commonest reason for having sex was because their friends had also had sex. Two hundred and seventy eight (61.9%) students reportedly had sex in the past 3 months before the survey, out of which 14.0% had sex with 4 or more sexual partners and 18% had sex more than once a week. Nineteen point eight percent of the currently sexually active students used condom during their last sexual intercourse. One hundred and forty six (27.2%) females had been pregnant at least once, out of which 75.3% had induced abortion. Students who watched pornographic movies (OR=2.189, CI=1.624-2.951) and those who dated the opposite sex (OR=2.839, CI=2.092-3.851) were 2 times more likely to have engaged in sexual intercourse than those who didn’t. Students who were sexually harassed were 5 times more likely to be sexually experienced than those who were not sexually harassed (OR=5.927, CI=4.408-7.971). Conclusion: There was a high rate of risky sexual behaviours amongst the secondary school students in Port Harcourt. Intervention program aimed at sexuality education and behavioural change should be inculcated into secondary school education curriculum in Port Harcourt.

Pattern and survival of biliary atresia patients; Experience in Southern Nigeria

Background: Biliary atresia (BA) has been a challenge to surgeons worldwide. Beyond the revolutionary surgical technique popularised by Kasai, liver transplantation has added renewed hope in the long-term outcome. In Nigeria, where late presentation is very common, there is need to assess the long-term results of the treatment options available to us. Aim: We aimed to evaluate the presentation and management outcome of BA and the long-term survival of BA patients seen in our practice. Materials and Methods: Cases of BA seen between January 2007 and December 2011 in three tertiary health facilities in South East Nigeria were included. Data obtained included age at presentation, clinical features, treatment offered and age at the time of death. Analysis was with the SPSS 17.0. Results: Twenty four patients comprising 10 (41.7%) males and 14 (58.3%) females were included in the study. The mean age of presentation was 4.02 (±214) months; range 1.75-11.0 months. Fifteen (62.5%) patients had surgery while 9 (37.5%) received medical treatment only. The mean age at death was 14.2 (±8.1) months; range 2.5-30 months. Conclusion: BA poses a daunting challenge in our practice. Outcome of treatment is still discouraging. We identified late presentation, lack of facilities to make early diagnosis, lack of adequately trained manpower to manage these children and lack of post-operative care and support for patients as the major challenges in the management of BA children in our region.