Prosper O. U. Adogu

Intimate Partner Violence among Women of Childbearing Age in a Primary Health Care Centre in Nigeria

This study assessed the prevalence and characteristics of intimate partner violence among women of childbearing age in a primary health centre. With interviewer-administered questionnaire, information on partner violence was elicited from three hundred women of childbearing age selected by systematic sampling in a primary health care (PHC) centre. Over 40% had experienced violence within the last 12 months. Type of marriage and partners education had effect on violence. Perceived reasons for violence were economic demand (56.1%), reproductive issues (42.5%), alcohol and drugs (61.2%). Forty eight per cent reported to family members. Only 1% reported to the Police. Intimate partner violence is a prevalent public health problem in eastern Nigeria. Health workers and social organisations should recognise the problem and offer necessary support, and women should be empowered to navigate through the problem.

Awareness and knowledge of disease surveillance and notification by health-care workers and availability of facility records in Anambra state, Nigeria.

Background: Disease surveillance and notification (DSN) is part of the Health Management Information System (HMIS) which comprises databases, personnel, and materials that are organized to collect data which are utilized for informed decision making. The knowledge about DSN is very important for the reporting of notifiable diseases. Objective: The aim of this study is to examine the awareness and knowledge of health-care workers about DSN, and availability of facility records in Anambra State, Nigeria. Materials and Methods: The study was a descriptive cross-sectional one in which relevant data were collected from health-care workers selected by a multistage sampling technique. Qualitative information was also elicited by key informant interviews, whereas an observational checklist, preceded by a desk review was used to examine the availability of facility records. Results: Although 89.8% of the health-care workers were aware of the DSN system, only 33.3, 31.1, and 33.7% of them knew the specific uses of forms IDSR 001, IDSR 002, and IDSR 003 (IDSR: Integrated Diseases Surveillance and Response), respectively. Knowledge of use of the various forms at the facility and local government area (LGA) levels were generally low, although the observational checklist revealed that IDSR 001 and IDSR 002 forms were predominantly found in primary health-care facilities. HMIS forms were less likely to be available in secondary health-care facilities (χ2=7.67, P=0.005). Conclusions: Regular training and retraining of concerned health-care workers on DSN at the LGA level is recommended. This should run concurrently with adequate and regular provision of IDSR forms, copies of the standard case definitions, and other necessary logistics to the health-care facilities by the local and state governments.

Assessment of the food hygiene practices of food handlers in the Federal Capital Territory of Nigeria

Background: The principle of food hygiene implies that there should be minimal handling of food items. Food handlers are thus expected to observe proper hygiene and sanitation methods as the chances of food contamination largely depend on their health status and hygiene practices. Objective: This study assessed the food hygiene practices of food handlers and made recommendations for improved food safety measures within food establishments in the Federal Capital Territory. Materials and Methods: The study design was cross-sectional descriptive. A multistage sampling technique was employed to select 168 food handlers of various types. Data was collected using a mix of quantitative methods (structured interviewer-administered questionnaires and observation checklist). Data were analyzed using the statistical package for social sciences version 14. Results: Four categories of food handlers were identified in 45 food establishments. Seventy-one (42.3%) of the subjects are males, whereas 97 (57.7%) are females. Most of them, 122 (72.7%), had secondary education and above, whereas 46 (27.3%) had primary education and below. One hundred and fifty (89.3%) of them wash their hands after the use of toilets, whereas only 44 (26.7%) change their hand gloves at work. One hundred and twenty (71.4%) of them undergo regular medical checkup, whereas 53 (31.5%) are isolated from workplace when ill. A few of them, 51 (30.4%) use sanitizers/disinfectants at workplace, whereas 38 (22.6%) check food temperature with thermometer. Also, 103 (61.3%) use ideal waste disposal methods at workplace (P < 0.01). Conclusion: Establishments should train staff regularly on basic personal hygienic techniques, self care and good house-keeping practices.

Parents' Perceptions of Timing of Initiation of Sexuality Discussion with Adolescents in Anambra State, South Eastern Nigeria

STUDY OBJECTIVE This study was aimed at determining the perception of the timing and practice of sexuality discussion among parents in South Eastern Nigeria. DESIGN A cross-sectional, descriptive, community-based study. SETTING The study was carried out in 3 randomly selected Local Government Areas in Anambra State, South Eastern Nigeria. PARTICIPANTS The study participants were parents with adolescent children resident in the study areas for at least 2 years. RESULTS Most parents opined that sexuality discussion should be initiated after puberty. Only 20% of them discussed reproductive health issues often with their adolescents, while another 20% never discussed such issues with their adolescent children. Topics most commonly discussed bordered on the adverse consequences of sex rather than measures for preventing them. About half of parents were willing to discuss contraception with their adolescent child. Predictors of parent-child communication were age, gender, and educational status. CONCLUSION Common reasons for low parental involvement in sexuality discussions were due to their lack of capacity and the perception that discussing such issues before puberty is ill timed. Therefore, measures should be taken to improve the capacity of parents to engage in such conversations to provide sexuality information to their teens.

Sexual health knowledge, attitude and risk perception among in-school and out-of-school female adolescents in Onitsha, Anambra State, Nigeria

Aim: Young people need protective information and skills in order to reduce the risk associated with unsafe sex. This study assessed and compared the sexual health knowledge, attitude and risk perception of in-school and out-of-school female unmarried adolescents in Onitsha North Local Government Area, Anambra State, Nigeria. Methods: A comparative cross-sectional design was used in which 391 in-school female adolescents (mean age: 15.9±1.4 years ) were selected from 25 private and 17 public schools in Onitsha North Local Government Area, Anambra State, Nigeria using multistage sampling method. A comparison group of 392 out-of school female adolescents (mean age: 15.5±2.5 years) was also selected from a major market in the same Local Government Area using cluster sampling technique. Data was collected from the respondents with pre-tested, interviewer-administered questionnaires on reproductive and sexual health knowledge, risk perception and attitude, sexual behaviour, contraceptive knowledge and sources of sexual health information. Results: In-school girls demonstrated better knowledge of sexual and reproductive health compared to their out-of-school counterparts. The awareness of fertile period, contraception methods, STI and HIV transmission and prevention were all significantly better among the in-school adolescents compared to their out-of-school counterparts (P<0.05). They also had markedly higher risk perception of getting pregnant (P<0.05) or acquiring HIV infection (P<0.05) compared to their out-of-school counterparts. Conclusion: About 21% of adolescents in this study area were involved in risky sexual behaviour and this was higher among the out-of-school adolescents than their in-school counterparts. All stakeholders in the state and the Local Government Area should come together and develop interventions that would improve the sexual health knowledge and sexual risk perception of the adolescents.

Assessment of level of adherence to antiretroviral therapy among human immune deficiency virus/acquired immune deficiency syndrome patients at Imo State University Teaching Hospital, Orlu, Nigeria

Background: Antiretroviral therapy (ART) is not a cure for human immune deficiency virus/acquired immune deficiency syndrome (HIV/AIDS), but rather it is used for optimal suppression of the viral load to an undetectable serum level, hence it remains a palliative measure to improve the quality of life and longevity by impeding the rate of disease progression. Objective: The objective was to evaluate the level of adherence, the prevailing contributory factors to adherence as well as nonadherence of HIV/AIDS patients to ART at Imo State University Teaching Hospital (IMSUTH), Orlu, Nigeria. Methodology: A descriptive cross-sectional study of HIV/AIDS patients receiving anti-retroviral drugs at IMSUTH, Orlu. It was carried out using interviewer - administered questionnaire involving 400 respondents. The collected data was analyzed manually using electronic calculator and results were presented in frequency tables. Results: The result showed a high level of adherence of HIV/AIDS patients to anti-retroviral drugs as 383 (96.2%) were adherent, while 15 (3.8%) were not adherent. Some reasons given for nonadherence to treatment were self-discouragement, toxicity of the drugs especially skin rashes, attitude of health workers, stigma, and distance to the hospital hence they may not be able to access their medications as and at when due. Conclusion: There is a significant high level of adherence of HIV/AIDS patients to ART at IMSUTH, Orlu, probably due to their high level of formal education as majority of the respondents 333 (83.0%) achieved at least a secondary level of education.

Cervical cancer: Knowledge of Risk Factors and Practice of Preventive Measures among Female Primary School Teachers in Urban Anambra State, Nigeria -

Aim / Background: Cervical cancer is one of the most common forms of cancer among women worldwide. This study was aimed at establishing baseline knowledge of cervical cancer risk factors and practice of its preventive measures among female primary school teachers in urban Anambra State, Nigeria. Methods: A descriptive cross-sectional study in which data on knowledge and practice variables were collected from 250 female school teachers aged 18 to 65 years, using self-administered questionnaires. Same was analysed and data presented in frequency tables. Result: Only 15(6.4%) of the respondents felt they were at risk of cervical cancer even as 149(59.6%) had no idea of any symptom of cervical cancer; and none knew early stages of the disease could present with no symptoms. Moreover, 137(58.3%) knew no risk factor for cervical cancer while a smaller proportion knew HPV infection 20(8.5%) and cigarette smoking 23(9.8%) as risk factors. Only 1(0.4%) respondent had ever had a cervical screening as over 75% of respondents reported not knowing about the screening test as their main reason for not doing the test. About 23% of respondents would recommend cervical screening to another woman. Conclusion: This study has shown very poor knowledge of cervical cancer and its risk factors; and even a poorer practice of cervical cancer screening among the respondents. Female teachers must be well informed about this disease in order for them to give the right information to their students. Therefore, in both formal and informal settings, regular and sustained health education on cervical cancer should be directed at this group.

Challenges of data collection and disease notification in Anambra State, Nigeria

Background/Objective: Disease surveillance and notification (DSN) in Nigeria have been characterized by weaknesses such as insufficiencies in health infrastructure, scientific methods, and concepts of operation; essential human, technical, and financial resources; and international or local policies as well as lack of intra- and intersectoral collaboration. These weaknesses in DSN system thus compromise efficiency and quality of data. This study examined the challenges of data collection and disease notification in Anambra state, Nigeria. Materials and Methods: This was a cross-sectional descriptive study of 270 healthcare workers selected by multistage sampling technique. Data collection was done using a mix method comprising interviewer administered questionnaires, health facility observational checklist, key informant interviews (KIIs), and desk review. Results: Commonest problems associated with DSN system as mentioned by the health workers were as follows: Most facility workers were not trained on DSN system (23.7%), lacked transportation (15.8%), poorly motivated/poor staff attitude (15.4%), inadequate supply of forms (11.8%), and poor funding (11.4%). An observational checklist on preparedness for DSN showed that 100% of primary and tertiary health facilities had facility records, while 81% at the secondary level had records. Only 51.9% facilities had community health officers (CHOs), while junior community health extension workers (JCHEWs) were more in primary health facilities compared to other levels of care (χ2 = 4.25, P = 0.040). Conclusion: Regular training program on DSN should be encouraged, while regular monthly supervision and quarterly meetings of health facilities should be organized for health facility workers. Regular and adequate information feedback should be emphasized.