Taiwo Gboluwaga Amole

A multicentre study on knowledge and attitude of nurses in northern Nigeria concerning female genital mutilation

Abstract Objective To determine the knowledge and attitude of nurses in northern Nigeria concerning female genital mutilation (FGM). Methods Cross-sectional study in which 350 nurses working in three tertiary health institutions in northern Nigeria were assessed, using a self-administered questionnaire, with regard to their knowledge of, and attitude to, FGM. Results Two hundred and sixty-five respondents (76%) were female, 190 (54%) were married. Most (249; 71%) were Muslims, and 228 (65%), of Hausa/Fulani ethnicity. Their ages ranged from 18–60 years with a mean of 29.3 ± 8.9. Among the respondents, 318 (91%) had heard of FGM; of these 127 (40%) knew no particular type of FGM. Only 155 (49%) could identify ‘Angurya’ and ‘Gishiri’ cuts as forms of FGM. Two hundred and forty-five (77%), 231 (73%) and 200 (63%), respectively, identified haemorrhage; risk of HIV, hepatitis, and tetanus; and painful sexual intercourse as possible complications of FGM. Thirteen (4%) would perform it and also would have it done on their daughters. Conclusion The nurses studied had a high level of awareness of FGM and a good general knowledge of complications associated with FGM. However, only half knew what ‘Angurya’ and ‘Gishiri’ cuts were. A few would perform FGM.

Prevalence, reasons and predictors for home births among pregnant women attending antenatal care in Birnin Kudu, North-west Nigeria

OBJECTIVE To determine the prevalence, reasons and predictors for home birth in a rural community. METHOD Descriptive cross sectional study which utilised a pretested interviewer administered semi-structured questionnaire to assess the place of delivery in their last childbirth among 410 pregnant women attending antenatal care in Birnin Kudu, Nigeria. Logistic regression analysis was used to assess the relative effect of determinants. RESULT PREVALENCE Of the 410 women, 248 (60.5%) delivered at home in their last childbirth. Self reported reasons: Home birth was opted for because of: lack of transportation 113 (45.6%), onset of labour was at night 104 (41.9 %), preferred birthing position 72 (29.0%), tradition 60 (24.2%), fear of surgery 42 (16.9%) and poor attitude of health workers 32 (12.9%). PREDICTORS The odds of giving birth at home was 3.88 times higher in women with informal education (adjusted OR 3.88; 95% CI: 2.51, 6.00) and the odds of giving birth at home was 0.27 for women with less than 5 deliveries compared with women with 5 or more deliveries (adjusted OR 0.27; 95% CI: 0.15, 0.49) after controlling for confounders. CONCLUSION The prevalence of home birth is high in Birnin Kudu and according to our respondents the main reasons for this practice are onset of labour late at night with lack of transportation and a limited choice of birthing positions. Provision of training and retraining of skilled birth attendants to assist women birthing in squatting positions would encourage women to deliver in the hospitals.

A prospective surveillance of ruptured uterus in a rural tertiary health facility in northwest Nigeria

Abstract Objective: To determine the frequency, cause and management outcome of ruptured uterus at a rural tertiary hospital. Methods: Cross sectional study which utilized a prospective surveillance of all cases of ruptured uterus that presented to the hospital from1 April 2010 to 31 March 2013. Results: Frequency: Over the study period there were 3001 deliveries and 44 cases of ruptured uterus; however, three died before surgery and 41 cases had exploratory laparatomy giving a prevalence of 14.7/1000 deliveries or 1 in 68 deliveries. Their ages ranged from 18 to 45 with a mean of 28.3 ± 6.6 years and parity varied between 1 and 13 with majority (62.7%) being grand multiparous. Twenty-five (61.0%) lived over 50 km away from the hospital. Causes: Prolonged/obstructed labour accounted for 33 (80.5%) cases, 23 (56.1%) had previous caesarean sections, while injudicious use of oxytocin was observed in 17 (41.5%). Management outcome: All the women who had surgery survived but 16 (39.0%) had anaemia, 10 (24.4%) had wound infection, three (7.3%) developed burst abdomen and 11 (26.8%) had prolonged hospital stay. There were 40 (97.5%) stillbirths of which 25 (61.0%) were fresh. Conclusion: The prevalence of ruptured uterus is high especially among women with prolonged/obstructed labour and previous caesarean section with associated high perinatal mortality.

Awareness of Oral Cancer in a Northwestern Nigerian State: Assessing the Knowledge, Opinion, and Practice of Traditional Healers and Herbalists

Background: Traditional healers/herbalists remain one of the most accessible and popular options of care to people suffering from cancers particularly at the community level in Nigeria. The majority of patients with oral cancer present at the terminal stage after exploring unorthodox care. This study assesses the awareness of oral cancer among traditional caregivers in Kano State, Northwestern (NW) Nigeria. Methods: Self-administered, structured questionnaires were administered to a cross section of 21 traditional caregivers. Results: Of the 21 traditional caregivers studied, the majority (66.7%) had never heard of oral cancer and only 7 (33.3%) were aware. The level of knowledge on oral cancer was assessed using a scoring system classifying respondents as having adequate (>50%) or inadequate (<50%) knowledge. There was a significant educational status gap as respondents with informal education had lesser knowledge than that of their counterparts who had formal education (61.9% versus 19.0%) (P = 0.012). Conclusions: It is important to have allied healthcare providers informed about oral cancer, as their knowledge and awareness of oral cancer and its risk factors, which were low in our study, are vital in prevention and early detection. Impact: This study provides an insight into oral cancer prevention using traditional herbalists who are popular caregivers for those seeking health-related solutions.

Quality of life of patients surgically treated for ameloblastoma.

Background: The surgical management of ameloblastoma can have a profound functional and psychological effect on a patients quality of life (QoL). The aim of this study was to compare the pre- and post-operative QoL outcomes of patients requiring surgical treatment for ameloblastoma. Patients and Methods: A total number of 30 patients were identified as fulfilling the criteria for this study. They included 18 males and 12 females, aged between 14 and 47 years with a mean of 27.3 years (standard deviation 10.2). Each patient completed a modified version of the University of Washington QoL questionnaire version 4, a day to surgery and postoperatively on the 7th day, 3 months, and 6 months. Results: Following surgical treatment of patients for ameloblastoma, the QoL decreased immediately after surgery. It then gradually improved over time and exceeded the preoperative value at 6 months postoperatively. When analyzed with respect to location, posteriorly placed tumors had the best postoperative QoL outcome. Patients expressed concern more about their appearance preoperatively while postoperative concerns were mostly focused on their ability to chew. Conclusion: Significant improvement occurred in QoL scores following surgical management of ameloblastoma. The small sample size utilized in this study limits a definitive conclusion. A larger multicenter study is therefore recommended.

Correlates of Female-Perpetrated Intimate Partner Violence in Kano, Northern Nigeria

Women are by no means the exclusive victims of intimate partner violence (IPV). This study assessed the lifetime prevalence and predictors of female-perpetrated IPV among public servants in Kano, Nigeria. Using a descriptive cross-sectional design and systematic sampling, pre-tested structured self-administered questionnaires were used to assess prevalence, types, and predictors of IPV among 302 married men. The lifetime prevalence of IPV was 66.8% (n = 177; 95% confidence interval [CI] = [60.7, 72.4]). Of surveyed men who have ever experienced violence, 78.0% (n = 138), 81.4% (n = 144), and 16.4% (n = 29) encountered physical assault, psychological aggression, and sexual coercion, respectively. After controlling for confounders, having ≥5 children, adjusted odds ratio (aOR) [95% CI] = 3.93 [1.16, 13.29], p = .027, and childhood experience of violence, aOR [95% CI] = 0.14 [0.05, 0.39], p = .0001, remained significant predictors of female-perpetrated IPV. In conclusion, female-perpetrated IPV is prevalent in northern Nigeria. Addressing IPV will require comprehensive violence prevention measures, including counseling and support for victims and exposed children.

A 14-Year Review of Craniomaxillofacial Gunshot Wounds in a Resource-Limited Setting

This study analyzed the prevalence, clinical characteristics, and management of civilian-type craniomaxillofacial gunshot wounds (CGSWs) seen over a 14-year period in a Northern Nigerian teaching hospital. A retrospective study of all hospital records relating to CGSWs from January 2000 to December 2013 was conducted to determine the prevalence of CGSWs. Information retrieved included site of injury, type of projectile, management protocol, as well as duration of hospitalization. A total of 46 admissions for CGSWs were recorded during the period under review from a total of 2,228 maxillofacial admissions. This gave a prevalence of 2.1% for CGSWs (95% confidence interval = 1.56–2.81). Sex distribution was 14.3:1 (M:F) with overall mean age of 32.9 ± 8.4 years. Average length of hospitalization was 17.7 (± 15.56) days. Management of CGSWs consisted of emergency care, preliminary intervention, definitive reconstruction, revisions, and rehabilitation. Conclusively, analysis of the yearly incidence of CGSWs showed that the incidence and severity increased within the past 2 years under review (18 cases, 39.13%; χ2 trend = 7.7, p = 0.006). This period was noted to correspond with heightened violence within the region mostly due to the acts of unknown gunmen and insurgents.

Deaths during tuberculosis treatment among paediatric patients in a large tertiary hospital in Nigeria

Background Despite availability of effective cure, tuberculosis (TB) remains a leading cause of death in children. In many high-burden countries, childhood TB is underdiagnosed and underreported, and care is often accessed too late, resulting in adverse treatment outcomes. In this study, we examined the time to death and its associated factors among a cohort of children that commenced TB treatment in a large treatment centre in northern Nigeria. Methods This is a retrospective cohort study of children that started TB treatment between 2010 and 2014. We determined mortality rates per 100 person-months of treatment, as well as across treatment and calendar periods. We used Cox proportional hazards regression to determine adjusted hazard ratios (aHR) for factors associated with mortality. Results Among 299 children with a median age 4 years and HIV prevalence of 33.4%; 85 (28.4%) died after 1,383 months of follow-up. Overall mortality rate was 6.1 per 100 person-months. Deaths occurred early during treatment and declined from 42.4 per 100 person-months in the 1st week of treatment to 2.2 per 100 person-months after at the 3rd month of treatment. Mortality was highest between October to December period (9.1 per 100 pm) and lowest between July and September (2.8 per 100 pm). Risk factors for mortality included previous TB treatment (aHR 2.04:95%CI;1.09–3.84); HIV infection (aHR 1.66:95%CI;1.02–2.71), having either extra-pulmonary disease (aHR 2.21:95%CI;1.26–3.89) or both pulmonary and extrapulmonary disease (aHR 3.03:95%CI;1.70–5.40). Conclusions Mortality was high and occurred early during treatment in this cohort, likely indicative of poor access to prompt TB diagnosis and treatment. A redoubling of efforts at improving universal health coverage are required to achieve the End TB Strategy target of zero deaths from TB.

Awareness, practice, and predictors of family planning by pregnant women attending a tertiary hospital in a semi-rural community of North-West Nigeria

Background: Nigeria′s maternal and perinatal health status is still among the poorest in the world, with a poor contraceptive prevalence rate and a high fertility rate. Aim: The aim of this study was to assess the level of awareness of family planning methods among women attending antenatal care, its uptake, and predictors of use. Subjects and Methods: This was a descriptive cross-sectional study, carried out at the antenatal clinic of Federal Medical Centre, Birnin Kudu, Jigawa state, Nigeria, using an interviewer administered questionnaire to assess the awareness and practice of family planning methods among 350 pregnant women, whom were selected through a systematic sampling technique from June 19, 2012, to August 26, 2012. Logistic regression analysis was used to assess the relative effect of determinants, adjusting for other predictor variables. Results: Of the 350 respondents, 319 (92%) had heard of family planning, of which 29% had ever used a method and the injectables were the most common method used. The use of family planning methods was significantly associated with respondents′ ethnicity, occupation, and level of education (P ≤ 0.05). The odds ratio of not using family planning methods was 2 times higher in women with informal education (adjusted odds ratio = 2.12; 95% confidence interval = 1.1-3.8). Conclusion: Awareness of family planning methods was high among the respondents surveyed, but the utilization was poor. Female education and empowerment would help to promote uptake in this setting.