Wasiu Olalekan Adebimpe

Larval habitats of mosquito fauna in Osogbo metropolis, Southwestern Nigeria.

OBJECTIVEnTo determine the larval habitats of mosquito fauna and possible impact of land use/ land cover changes on the epidemiology of mosquito-borne diseases in Osogbo metropolis, Southwestern, Nigeria.nnnMETHODSnAll accessible larval habitats were surveyed between May and September, 2011 in Osogbo metropolis while Land Use/ Land cover of the city was analyzed using 2 Lansat Multispectral Scanner satellite imagery of SPOT 1986 and LANDSAT TM 2009.nnnRESULTSnA total of six species namely, Aedes aegypti, Aedes albopictus, Aedes vittatus, Anopheles gambiae complex, Culex quinquefasciatus and Eretmapodite chrysogaster were encountered during the study. The occurrence and contribution of disused tyres was significantly higher (P<0.05) than the other habitats encountered, while there were no significant differences in the contribution of gutters/run-offs, septic tanks/ drums, ground pools/open drains and discarded containers to the breeding of mosquitoes (P>0.05). The accessible land use/ land covered of the study area between 1986 and 2009 showed that the wet land coverage and settlement area increased from 0.19 to 9.09 hectare and 1.00 to 2.01 hectare respectively while the forest area decreased from 60.18 to 50.14 hectare.nnnCONCLUSIONnThe contribution of the habitats coupled with the increasing rate of flooded environment which could provide ample breeding sites for mosquitoes call for sustained environmental sanitation and management in Osogbo metropolis.

Hygiene practices among workers in local eateries of Orolu community in south Western Nigeria

Background: Activities of local food premises and monitoring of food handlers are usually not regulated. Aim: The objective of this study was to determine food hygiene (FH) practices among food handlers in rural communities in South Western Nigeria. Subjects and Methods: Descriptive cross sectional study was carried out among 235 food handlers; data collection was by interviewer administered questionnaires. Using the SPSS software, multivariate analysis in two separate models was done to explore the predictors of correct knowledge and good hygiene practices. The model fit was assessed as good using the Hosmer and Lemeshow test. Results: Mean age of respondents was 31.8 (10.8) years. Of the respondents (134) that had training, 17.2% (23/134) had formal training, and 82.8% (111/134) had apprenticeship; about 31.5% (74/235) of respondents maintained a good level of hygiene in their practices. Significant predictors of correct knowledge were found to be being trained (significant 0.01, odds ratio [OR] 2.4, 95% confidence interval [CI] 1.2–4.8) and receiving the training as an apprentice (significant 0.01, OR – referent group); or in a formal setting (significant 0.01, OR 3.3, 95% CI 1.6–7.0) and having no formal education (significant 0.04, OR – reference group). Conclusion: Good knowledge and attitude but low level of good practices toward FH characterized food handlers under study.

Chikungunya Virus Seroprevalence and Associated Factors among Hospital Attendees in Two States of Southwest Nigeria: A Preliminary Assessment

ABSTRACT Chikungunya virus (CHIKV) is a re-emerging pathogen causing long-term polyarthritis and encephalitis. In conducting a preliminary investigation, we hypothesized that there is no serologic evidence of CHIKV infection among attendees of selected hospitals in Lagos and Osun States, Nigeria. Sera from 304 consecutively selected participants were screened for CHIKV IgG and IgM using ELISA. Findings were analyzed vis-à-vis participants’ demographic and clinical data. Over 90.0% of the participants had never heard of CHIKV despite the fact that a large proportion of them (88.8%) had secondary/tertiary education. Overall, 41.8% were positive for, at least, one antibody type (IgG or IgM), while about 16.0% of the participants had dual seropositivity (CHIKV IgG and IgM) with gender as associated factor (odds ratio [OR]: 2.8, p = 0.03). Prevalence rates were 31.8% and 38.4% for CHIKV IgG and IgM, respectively. Only hospital location (Osogbo) was associated with CHIKV IgG (OR: 2.2, p = 0.009), while gender alone was associated with CHIKV IgM (OR: 3.0, p = 0.001). Participants seropositive for CHIKV antibodies were mostly adults (18–59 yrs) belonging to the active work-force; five (22.7%) and three (20.0%) of the pregnant participants had CHIKV IgG and IgM, respectively. Detection of CHIKV IgM in some participants might make them potentially infectious to the newborn and mosquito vectors. Importantly, participants positive for either IgG or IgM had fever (72.8%, 67.2%) and general body pains (61.7%, 57.6%), respectively. This ELISA-based study revealed serologic evidence of CHIKV infection among hospital attendees in Lagos and Osun states with the group-specific prevalence rates being considerably high. Abbreviations:Chikungunya virus (CHIKV); Chikungunya (CHIK); enzyme-linked immunosorbent assay (ELISA); immunoglobulin G or M (IgG/IgM); odds ratio (OR); non-structural proteins (nsP); hemagglutination inhibiting (HI); complement fixing (CF); neutralization test (NT); immunofluorescence assay (IFA); plaque reduction neutralization test (PRNT); confidence interval (CI); analysis of variance (ANOVA); body temperature (BT); Building Nigeria’s Response to Climate Change (BNRCC).

Prevalence and predictors of erectile dysfunctions among men on antiretroviral therapy in South-Western Nigeria

Background: Erectile dysfunctions (EDs) are common presentations among men on anti retroviral therapy, many of who had a course to discontinue anti retroviral drugs or search for alternative treatments. Aim: This study assessed the prevalence and predictors of ED among men on anti retro viral therapies (ART) in a Nigerian population. Subjects and Methods: It was a descriptive cross sectional survey among 234 HIV positive men on anti retroviral therapy selected using stratified sampling method after excluding for co morbidities. Research instrument was semi structured interviewer administered questionnaire, and data were analyzed using the SPSS software version 17.0 (Chicago IL, USA), while binary logistic regression and Chi square test were used to demonstrate association between selected categorical variable. Results: Mean age of respondents was 37.1 (1.6) years, 85.6% have not missed their medications, self reported adherence was reported as good among 213 [(90.8?%) 213/234], though calculated adherence was 90% among as many as 201 [(85.6%) 201/234]. Pattern of EDs revealed weak erection among 42 [(37.8%) 42/111], 15 [(13.5%) 15/111] said they could no longer achieve erection, 33 [(29.7%) 33/111] said they could not maintain erections, while 27 [(24.3%) 27/111] presented with loss of libido. Delayed and premature ejaculations were reported among 24 [(21.6%) 24/111] and 8 [(7.2%) 8/111] respectively. About 14% (33/234) of respondents said that anti retroviral drugs could have caused their ED while 78% (183/234) said it should not. A statistically significant association exists between having weak erections and age above 65 years and calculated the adherence <95%, while none exists between having weak erections and missing pills. Conclusion: Anti retroviral drugs are common causes of EDs. Concerns of clients should always be addressed most especially issues that may compromise adherence.

Knowledge, Attitude, and Practice of Use of Safety Precautions Among Health Care Workers in a Nigerian Tertiary Hospital, 1 Year After the Ebola Virus Disease Epidemic

BACKGROUNDnSeveral studies have found that compliance with universal precautions (UP) reduces the risk of exposure to diseases transmitted through blood and body fluids. Several efforts were made during the 2014 Ebola virus disease (EVD) outbreak in Nigeria to ensure a better behavioral change toward the practice of UP.nnnOBJECTIVESnThis study assessed knowledge, attitude, and practice of the use of universal safety precautions among health care workers in a tertiary hospital in Osun State in southwestern Nigeria, 1 year after the containment of the EVD epidemic in Nigeria.nnnMETHODSnDescriptive cross-sectional study among 274 health care workers of LAUTECH Teaching Hospital Osogbo, selected using systematic sampling method. Data collected using semistructured, pretested questionnaires were analyzed using SPSS software version 17.0 (Chicago, IL, SPSS Inc.).nnnFINDINGSnTwo hundred twenty (80.3%) washed their hands regularly after procedures, 256 (93.4%) used gloves regularly when caring for all patients, 100 (36.5%) said they occasionally recap needles carefully, and 250 (91.2%) said they properly handled and disposed sharp instruments and wastes. About 224 (81.8%) had good mean knowledge score, 154 (56.2%) had a positive attitude score, and 192 (70.1%) had a good mean practice score for UP among respondents. The practice of UP was statistically significantly associated with gender, years of work experience (Pxa0= .002), and knowledge of (Pxa0= .039) and attitude about UP (Pxa0= .007).nnnCONCLUSIONSnThe good knowledge and practice scores of UP were associated with better attitude toward handwashing and the use of gloves during the post-EVD period compared with the pre-EVD period. A significant proportion still recap used needles just like during the pre-EVD period.

Knowledge, attitudes and practice of emergency contraception among medical doctors attending a continuing medical education programme in Osogbo, south-western Nigeria

Objective : To ascertain the major determinants of perinatal transmission of HIV among HIV positive womenxa0attending ANC and delivery at the University of Maiduguri Teaching Hospital, Maiduguri. Patients and methods : A prospective case control study of 52 HIV positive pregnant women who werexa0attending ANC and delivery at university of Maiduguri Teaching Hospital (UMTH) was carried out. Knownxa0HIV positive mothers sent from the adult HIV clinic and those found during ANC HIV screening andxa0diagnosis using rapid tests were recruited, while Fetal diagnosis of HIV was done using polymerase chainxa0reaction (PCR) technique at 6 and/or at 12 weeks of birth age. Socio demographic and obstetrics history werexa0obtained and analyzed using SPSS version 11 and test of significance was carried out using chi square tests. Results : Of the 52 women that were found to be HIV positive, the perinatal transmission rate was 11.5%.xa0Elective caesarean section (ELCS) was offered to 11(21.2%) and all the babies delivered through ELCS werexa0negative for HIV. Advanced maternal age (X 2 =33.53 P <0.001), Low CD4 count (X 2 =15.58 P =0.016), highxa0maternal viral load (X 2 =21.85 P =0.005), prematurity (X 2 = 9.872 P= 0.007), low birth weight (X 2 = 63.80 P <xa00.001) and birth asphyxia(X 2 = 24.149 P< 0.001) were the major determinants of perinatal transmission ofxa0HIV infection in this study. Conclusion : The perinatal transmission of HIV is high. Prompt identification of both maternal and fetal risksxa0factors and Effective interventions aim at minimizing the impact of these factors before or during pregnancyxa0will help to lower some of the preventable determinants of perinatal transmission. Recommendations : A prenatal and antenatal risks reduction strategy should be advocated. All effort shouldxa0be geared toward identifying those positive and minimized or modify risks factors through behavior change,xa0prompt initiation of treatment and prophylaxis for those found positive with a view to reduce the incidence ofxa0perinatal transmission. Key Words : perinatal transmission, HIV, maternal, fetal determinants, MaiduguriBackground : Jadelle is a set of two flexible cylindrical implants consisting of a dimethylsiloxane/xa0methylvinylsiloxane copolymer core enclosed in thin-walled silicone tubing. It is an improved version ofxa0Norplant. Worldwide, it is found to be effective, safe, reversible and convenient for many users. Objective : To determine the acceptance rate, the Socio-demographic profile of the clients, post insertionxa0complications and reason for discontinuation of the method among its acceptors in Aminu Kano Teachingxa0Hospital, Kano. Study design : This is a retrospective descriptive study, involving all acceptors of Jadelle Subdermal implantxa0in the family planning unit of Aminu Kano Teaching Hospital Kano, North western Nigeria. Results : A total of 1505 clients accepted contraceptive methods during the study period. Out of these, 102 hadxa0Jadelle inserted, giving a rate of 6.8%. All the clients who accepted Jadelle had it inserted for child spacing.xa0The mean age of the clients at insertion was 28.9 years ± 6.1, the mean parity at insertion was 3.3± 1.8, whilexa0the mean weight at insertion was 63Kg ±11.4.xa0About 94% of the clients had secondary and tertiary education. 42.2% of the clients had used a modernxa0contraceptive method previously while the remaining 57.8% were using a modern method for the first time.xa0Nine clients reported post insertion complication, pain at the site of insertion was reported by three clients, andxa0pruritus was reported by one client and intermenstrual bleeding by five of the clients. Five womenxa0discontinued the method; 3(60%) was due to menorrhagia. Conclusion : The continuation rate of the method is high (95.1%). Majority of the acceptors (98%) had formalxa0education, only 2% of the acceptors were illiterate. Public enlightenment will improve its use among the nonxa0literate women. Keywords : Jadelle, Subdermal implant, Kano, Northern NigeriaContext : Hysterectomy is a major gynaecological surgical procedure which involves the removal of thexa0uterus, occasionally structures in the adnexae are removed alongside depending on the need to do so.xa0Hysterectomy can be approached Abdominally, vaginally or even with laparoscopic assistance. Objective : This study was embarked on to ascertain the prevalence, indication, pattern and outcome ofxa0hysterectomy over a four (4) year period. Study design, Settings and Subjects : This study is a four (4) year retrospective review of all cases ofxa0hysterectomy either for gynaecological or obstetric reasons managed at BUTH from 1st January 2011 throughxa031st December 2014. Result : During the period under review a total of 127 hysterectomies were done for gynaecological andxa0obstetrical indications, However, only 103 case records were available. Gynaecological indication was thexa0reason for hysterectomy in 95 (92.2%) , while the remaining 8 (7.8%) had hysterectomy for Obstetricalxa0indications. The mean age of patients in our study was 49.2±12.6 years; there was an age distribution of 18-90xa0years. The mean age of patients who had abdominal hysterectomy was 45.3±7.4 years, while the mean age forxa0patients who had vaginal hysterectomy was 68.7±5.3 years. Abdominal hysterectomy accounted for 90(xa087.4%) , while vaginal hysterectomy accounted for the remaining 13(12.6%) ; there was no case ofxa0laparoscopically assisted vaginal hysterectomy done. There were three(3) deaths following emergencyxa0hysterectomy performed on account of primary postpartum haemorrhage. Conclusion : Hysterectomy remains a major gynaecological procedure. Necessary steps are needed to ensurexa0that gynaecologist acquire skills for hysterectomy especially vaginal hysterectomy and even laparoscopicxa0assisted hysterectomy.Background : Management of critically ill women in intensive care units (ICU) is crucial in reducingxa0maternal mortality. This study sought to determine the ICU obstetric and gynaecology utilization rate,xa0indications for admissions, assess the outcome and risk factors associated with mortality. Design/ settings : A retrospective descriptive study of admissions in a multidisciplinary ICU setting in axa0University Teaching Hospital in Nigeria. Methods : Records of obstetric and gynaecological patients admitted to the ICU over a 5-year period werexa0entered into a computer. Data included demographic and clinical characteristics of the patients, interventionsxa0performed and outcomes of patients ICU care. Data was analysed using SPSS version 20 for windows. Results : The MMR was 870 per 100,000 live births. The incidence of obstetric and gynaecologicalxa0admissions to the ICU was 5.2% (37/706) of all admissions. 20 (58%) were obstetric cases, mostly severexa0PET/eclampsia15 (40.5%), 42% of the women were admitted for complications of gynaecologicalxa0procedures. Commonest complication was adult respiratory distress syndrome (ARDS). The mortality wasxa016 (43%) overall, 10 (62.5%) were obstetric cases mainly PET/eclmpsia (56%). The likelihood of Obstetricxa0mortality was twice that of gynaecological mortality (OR 2.5, 95% CI 0.99 – 6.16, P<0.026). Factors relatedxa0to poor outcomes were 2 or more interventions (P=0.001). Conclusion : Obstetric and gynaecology ICU utilization was low considering the high MMR. The majorxa0indication for admission was severe PET/eclampsia. The need for ventilatory support may predict poorxa0outcome. There is need for dedicated obstetrics and gynaecology ICU to make access easier for Near Missxa0cases. Keywords : Obstetrics; Critical care; Gynaecology; Intensive care unitBackground : Endometrial biopsy is a commonly performed procedure with a wide range of possiblexa0histopathological diagnoses. Objective : To determine the clinical spectrum, frequency and age distribution of endometrial pathologies atxa0the University of Maiduguri Teaching Hospital (UMTH), Maiduguri. Methods : This was a 20 year retrospective review of all histologically analysed endometrial samplesin thexa0histopathology Department of the UMTH, Maiduguri, from January, 1989 to December, 2008 inclusive. Results: A total of 801 endometrial biopsies were reviewed during the study period. The age ranged from 14-xa075 years with a mean of 32.5 years ± SD 10.4 years. The results showed that most (41.7%) of the patients werexa0in their3rd decade of life. Simple endometrial hyperplasia was the leading histopathological diagnosisxa0accounting for 56.2%, followed by retained products of conception representing 10.2%. Malignantxa0conditions were diagnosed in 62 patients (7.7%), of which the most common was choriocarcinoma (3.8%),xa0while endometrial cancer was found in 1.5%. Conclusion : The commonest histopathological diagnosis of endometrial samples in UMTH is simplexa0endometrial hyperplasia. Careful treatment and follow up of women with endometrial hyperplasia isxa0essential. Regular audit of endometrial samples as a follow up to this review is recommended. Key words : endometrial samples,histopathological pattern, MaiduguriIt is very difficult to determine the exact prevalence and reproductive implications of congenital uterinexa0anomalies, because majority of the cases are missed, since they are often asymptomatic and the poor accuracyxa0of the diagnostic tools commonly used. Although, many of these women with congenital uterine anomaliesxa0carry their pregnancies to term with live deliveries without any complication, some experience pregnancyxa0losses. A 29 year old, G 3 P 0 +2 lady with 2 previous first trimester spontaneous abortions had an emergency xa0caesarean section for cervical stasis at 38 Weeks gestation. Findings at Surgery were consistent with uterinexa0Didelphys. Her Post-operative period was uneventful. Thus, bad obstetric history such as recurrentxa0spontaneous abortions as seen in this patient should be a pointer for proper evaluation to exclude congenitalxa0uterine anomalies. Keywords : Uterine didelphys, Term pregnancy, Emergency caesarean section, private health care facility inxa0Lagos.

Menstrual pattern and disorders and impact on quality of life among university students in South-Western Nigeria

Background: Menarche is one of the signals of a woman′s transition from childhood to adulthood. Abnormal menstrual pattern could cause morbidities that may disrupt daily activities. Aim: To assess the pattern of menstrual disorders and impact on the quality of life among university students in South-Western Nigeria. Subjects and Methods: This descriptive, cross-sectional study was carried out among 494 university students in South-Western Nigeria, selected using multistage sampling method. Research instruments were semi-structured, self-administered, and pretested questionnaires. Data were analyzed using the SPSS software, version 17.0 (Chicago, IL, USA). Results: Mean age at menarche was 13.6 (1.1) years. About 89.1% (440/494) were aware or foretold of the coming of menarche. Major sources of information include parents, relatives, friends, and health care workers. About 82.8% (409/494) had regular monthly menstrual flow pattern, 21.9% (108/494) had menorrhagia, 16.0% (79/494) had oligomenorrhea, 9.1% (45/494) had polymenorrhea, while 65.8% (325/494) had occasional associated dysmenorrhea. About 10.7% (53/494) had treated dysmenorrhea in a health facility in the last 1 year. Menstruation usually puts tension on 46.2% (228/494) of respondents, disrupted work at school in 38.9% (192/494), and at home among 42.9% (212/494) of them, while it had prevented going to school for at least 1 day in the last 6 months among 15.6% (77/494) of respondents. Girls with irregular menstrual pattern were 1.4, 1.8, and 1.6 times more likely to have experienced pressure or lenition on them, had school work, and home work disrupted, respectively. Girls who were precounseled about menarche were twice less likely to have had disruptions of school activities compared to those who were not precounseled (odds ratio = 0.5, 05% confidence interval: 1.96-3.01, P = 0.01). Conclusion: This study demonstrated that menstrual disorders constitute a challenge to a significant percentage of adolescents. This also underscores the need for guided sexuality and menstrual related information targeted at youths.

A survey of clients and ethical perspectives of voluntary tubal ligations in the South-Western Nigeria

Background: Acceptance of voluntary tubal ligation is gradually gaining wide acceptability in the developing countries. Aim: This study described the sociodemographic characteristics of acceptors of voluntary female surgical sterilizations (VSS) and assessed clients′ perception of compliance of health care providers with ethical, statutory, and policy requirements in family planning (FP) practices. Subjects and Methods: Retrospective, analytical study of VSS within the period January 2012 and June 2013, followed by a descriptive cross-sectional study of 96 sterilized clients from randomly selected health facilities in the South-Western Nigeria. The resultant data collected using interviewer-administered questionnaires were analyzed using SPSS software version17.0 (Chicago, IL, USA). Results: Seventy-two (75.0%) had the VSS procedure carried out during the cesarean operations. All clients were counseled by the surgeon/gynecologists on benefits of the procedure, though only 13.6% (13/96) received additional counseling from the FP care providers. All were counseled on benefits of the procedure while 75.0% (72/96) were counseled on the risk associated with the procedure and 67.7% (65/96) were offered alternatives to the procedure. No respondent was offered incentives for accepting tubal ligation. There was a statistically significant association between having a voluntary sterilization done on clients and having counseled client on benefits of the procedure (P - 0.01), having sterilization done based on both client and her husband′s decision (P - 0.05), and clients voluntarily accepting sterilization (P - 0.02). Conclusion: Statutory and ethical requirements being followed in VSS were performed and reviewed in this study. Clinical specialist working in the areas of tubal ligations should always endeavor to send their clients to FP clinics for a more thorough secondary counseling on their chosen method.

Obesity indices as predictors of pattern of self-reported arthritis among elderly women in Southwestern Nigeria

Objectives: This study assessed obesity indices and pattern of arthritis among elderly women in Osun State, Southwestern Nigeria. Methods: The cross-sectional descriptive study was carried out among 350 elderly women selected by multistage sampling technique. Research instruments used in data collection were semi-structured, interviewer-administered pre-tested questionnaires that were analyzed using the Statistical Package for Social Sciences software version 17.0. Results: The mean age of the participants was 69.1 (±1.4)u2009years. A total of 232 (66.3%) of them had complaints of joint pains (Awoka as expressed in the local language). Pattern of arthritis showed that 172 (74.0%) had recurrent joint pains, while 35 (15.1%) had joint swelling; the knee joint was mostly affected. A total of 97 (28.0%) were overweight while 84 (24.0%) were obese. Obese women were twice more likely to have arthritis when compared to the nonobese (odds ratio: 2.4, 95% confidence interval: 1.8–9.4, pu2009=u20090.001). Conclusion: There is a need to give high priority to weight reduction strategies targeted at the elderly and the entire population.

Perceptions and Use of Antimicrobials Among Staff of a University Community in Southwestern Nigeria

Public attitude and knowledge of antibiotics are determinants of rational use of antibiotics and prevention of antimicrobial drug resistance. This study assessed perception and use of antimicrobials among staff members of a University in Southwestern Nigeria. Descriptive cross-sectional study among 450 staff members of Osun State University in Southwestern Nigeria using multistage sampling method was carried out. Semi-structured self-administered and pre-tested questionnaires were used in data collection. Data were analyzed using the SPSS software Version 17.0. Binary logistic regression models for the outcome variable of composite knowledge and attitude scores toward antimicrobials and their possible predictors were done and level of significance was set at p values ≤ .05 and confidence interval of 95% for all inferential analyses. Mean age of respondents was 26.8 (±11.1) years, and 331 (73.6%) had up to tertiary-level education. One hundred eighty-three (40.7%) and 267 (59.3%) had good and poor knowledge scores, respectively; 175 (38.9%) had positive attitude whereas 275 (61.1%) had negative attitude toward the use of antibiotics. About 279 (62.0%) were informed about judicious use of antibiotics, 398 (88.4%) had ever used antibiotics in the past 1 year with the Ampicillin and Cloxacillin combinations being the most commonly used. Eighty-eight (22.1%) used antibiotics for more than 10 days as at the last use. Predictors for having good knowledge and attitude include age, educational status, and ever having used antibiotics. Inadequate knowledge and attitude toward antibiotics were observed, and this necessitates sustained health education campaign to stakeholders on rational use of antibiotics, especially toward prevention of antimicrobial resistance.