Beyond prevalence and pattern: problematic extent of alcohol and substance use among adolescents in Ibadan South-west Nigeria

Background

Previous research on adolescent alcohol/substance use in Nigeria had focused on the pattern of use without consideration for the extent of use. Socio-demographic correlates have also not been well explored. Information about socio-demographic correlates can also inform target-points in preventive strategies. Knowledge of the prevalence of problematic pattern of alcohol/substance use can inform the inclusion of rehabilitation strategies in intervention policies.

Objectives

To determine the prevalence, pattern and extent-as well as socio-demographic correlates-of alcohol/substance use among a cohort of adolescents in Nigeria.

Methods

Pattern and extent of alcohol/substance use was examined using the CRAFFT instrument.

Results

A total of 538 adolescents with a mean age of 15.1 ± 1.4years returned completed questionnaires. 12-month prevalence of alcohol and other substance use was 21.4%. About 46% of those who reported use of alcohol or any other substance had a CRAFFT score of >2 which suggests problematic pattern of use. Older age, male gender, parental alcohol and substance and lower than average school performance were independently associated with 12-momth use of alcohol or any other substance.

Conclusions

Adolescent alcohol and substance use is common in Nigeria and a large proportion of users show a problematic pattern of use that warrants rehabilitative intervention.     

Clinical and microbiological profile of adult inpatients with community acquired pneumonia in Ilorin,North Central,Nigeria

BackgroundThe optimal management of community acquired pneumonia (CAP) depends on the clinical and microbiological profile in the locality.ObjectivesTo determine the clinical and microbiological profile of patients admitted with CAP in Ilorin, Nigeria.MethodsOne hundred and two consenting consecutively selected patients with clinical and radiologic confirmation of CAP were recruited in 12 months. The socio-demographic, physical examination and laboratory/radiologic parameters were documented in a questionnaire. Microbiological evaluation of their sputum was done and blood samples were taken for complete blood count, culture, serum urea and serological evaluation for atypical bacteria and some viral pathogens.ResultsCAP constituted 5.9% of the total medical admissions during the one-year study period. The mean age of the patients was 49 ± 22 years with the largest frequency in those aged 65 years and above. The commonest symptoms were shortness of breath (96.1%) and cough (94.1%), with a median duration of 3 days from symptom onset to admission. Systemic hypertension was the commonest comorbid illness (25/102; 24.5%). Klebsiella pneumoniae was the predominant pathogen isolated (20/102; 28.1%). The susceptible antibiotics were Imipenem, Ceftazidime and Ceftriaxone. Intra-hospital mortality was 17.6%. CURB – 65 score of ≥ 2 and the presence of complications of CAP were the independent predictors of mortality.ConclusionCAP constitutes a significant disease burden in Ilorin, Nigeria. Typical bacteria accounted for over half of the pathogens isolated from the patients with gram negative agents predominating. This highlights a possible shift in the microbiological profile which could guide empirical treatment.     

Sex problems after menopause: a study of fifty married couples treated in a sex counseling programme

This is a study of the sexuality of 50 couples among whom all of the women were post-menopausal. The population was seen in the Sex Counseling Service at Yale for treatment of sexual problems. The impact of biological changes accompanying the menopause appears to influence sexual interest, behaviour and response of both women and their male partners. The possible importance of oestrogen effects on perception and the significance of perceptual changes at menopause to the functioning of the sex response cycle is reported. Findings also include male emotions generated by female biological changes which inhibit male sexuality.     

Train the trainer: improving health education for children and adolescents in Eswatini

BackgroundEswatini has the highest HIV prevalence in the world. One issue at the root of health in Eswatini is a lack of basic health knowledge among children and adolescents, which amplifies the likelihood of disease transmission and poor health outcomes.ObjectivesTo address the lack of basic health education and to improve health knowledge, we developed and evaluated a medical education program to train shepherds (train-the-trainer) who are supporting children and adolescents at local CarePoints.MethodsTo determine the change between pre-test scores and post-test scores, both a paired t-test and mixed-effects regression were performed.ResultsThe program had 67 total participants, mostly female (67.2%), with an average age of 27.1 years. Following the medical education program, participants had a statistically significant increase in post-training scores. Years of prior schooling, age, and gender did not show a statistically significant effect on post-training scores.ConclusionTeaching basic health education knowledge to CarePoint shepherds is effective to increase their knowledge and awareness with respect to relevant health topics. This model of directed medical education could be expanded to other community members in Eswatini to bridge gaps in health knowledge and disease awareness. A similar model could be employed in other developing countries with limited health education and limited access to health information.     

Effects of sex steroids on the development of sexual dimorphism in mouse innominate bone

The sexual dimorphism of the innominate bone was examined in 14 strains of mice. In female mice of all strains, the pubis was significantly longer and thinner than that in the strain-matched males. In 13 of 14 strains, the ischium in the male was longer and thicker than in the female. In the testicular-feminized male (Tfm) mouse, the ischium was longer and thinner than that in the wild-type male, resembling that of the wild-type female. The pubis of the Tfm mouse was longer than in the wild-type males. The pubis width in the Tfm mouse was between those of the wild-type male and female. Gonadectomy at ages of 5, 10, 20, 30, and 60 days in both sexes showed that the ischium develops as the female type when sex hormones are absent. In contrast, postnatal testicular androgen induces the male-type ischium. Gonadectomy at 60 days had a slight effect on the pubis, indicating that sexual dimorphism of the pubis was determined before 60 days of age. Estrogen receptors (ER) were immunohistochemically demonstrated in bone cells of 0- to 60-day-old mice. ER was found exclusively in the periosteum of the pubis at the day of birth; however, it appeared in bone cells of all parts of pelvis at 10–60 days. These results indicate that sexual dimorphism of the pubis is consistent for the 14 mouse strains examined, and that the shape of the pubis is determined by sex steroids before 60 days of age. Since ER exist in the bone cells, morphogenesis of the pelvis may be regulated by these sex steroids.© Willey-Liss, Inc.     

Factors shaping the provision of sexual health education for adults with acute coronary syndrome: A scoping review

ObjectiveEach year, 63,000 Canadians are diagnosed with acute coronary syndrome (ACS)and 73 % survive. Sexual health education for ACS survivors is recommended but is not routinely provided. A scoping review was performed to inform health care providers about factors shaping sexual health education for ACS survivors.MethodsThree databases were searched, 208 studies were screened, and 24 were included in this scoping review. Significant points from the selected studies were charted and synthesized.ResultsThis review confirmed absent to limited provision of sexual health education to individuals with ACS. Key factors influencing lack of provision of sexual health were categorized according to macro, meso, and micro levels. At the macro level, societal and cultural factors were noted. The meso level included healthcare environment and limited healthcare provider knowledge. At the micro level, healthcare professional-healthcare consumer relationships and role clarity were noted.ConclusionA sex positive approach may facilitate provision of sexual health education.Practice implicationsThis scoping review points to the need to use a sex positive lens to identify and remove barriers to facilitate the provision of sexual health education. Providing this education may result in reduced fear, depression, and anxiety in ACS survivors.     

Knowledge and indulgence in substsance abuse among adolescents in Anambra state,South-East Nigeria

BackgroundSubstance abuse is a growing societal problem with adolescents being at increased risk. The few studies in Nigerian adolescents have not factored in their knowledge base with regard to the concept of substance abuse.ObjectivesThis study determined the indulgence in and knowledge of substance abuse and associated factors among adolescents.MethodsThis was a questionnaire based study involving 10 to 19year olds recruited from an adolescent summer camp in Anambra state, South-East Nigeria.ResultsThe data of 276adolescents was analyzed, male–91, 33%, M: F = 1: 2. Mean age was 16.4 ± 1.4years. 13.8% (38) accepted they had abused substances in the past; 74.3% (205) had the correct knowledge of the meaning of substance abuse; 10.1% (28) admitted taking substances for pleasure. The substances taken included Alcohol (67.9%), Cigarette (25.0%), Tramadol (10.7%), Cocaine (7.1%), among others. Multiple substances were taken 28.6% of the time.Age category had no significant association with the abuse of substances (X2–2.656, p = 0.282). Stratified by age category, gender had a significant association with substance abuse in Late adolescence (n = 11; M–9, 81.8%; F–2, 18.2%; X2 = 6.893, p = 0.016) but not Mid-adolescence (n = 27; M – 10, 37.0%; F – 17, 63.0%; X2 = 0.749, p = 0.500).ConclusionAn unacceptable proportion of the adolescents were already exposed to substances/drugs in spite of having suboptimal knowledge. Adolescents need to be educated on substance abuse and its dangers in order to curb this in the society.     

Effects of call reminders,short message services (SMS) reminders,and SMS immunization facts on childhood routine vaccination timing and completion in Ilorin,Nigeria

BackgroundReminders via mobile devices deployed as short message services (SMS) or calls have been identified to be a useful strategy in improving routine immunization uptake in several countries.ObjectiveTo identify the timeliness of appointments with reminders (calls or SMS), SMS health education and the routine care, and the vaccination completion rates in Ilorin, Nigeria.MethodMother-infant pairs presenting for the first vaccination appointment were randomized into four (three interventions, one control) groups, each consisting of 140 participants. Intervention groups were reminders via calls (A), SMS reminders (B), immunization fact SMS messages (C) and controls on usual care (D). Reminders were made a day before the appointment while SMS immunization facts were sent at five weeks, nine weeks and eight months. Appropriate timing was defined as the scheduled visit ±3 days.ResultsThe immunization completion rates after the nine months'' visit were 99.2%, 99.3%, 97% and 90.4% for Groups A, B, C and D respectively. Compared with controls, Group A had the highest odds [AOR 8.78 (6.10, 12.63)] of presenting at an appropriate time, followed by Group B [AOR 2.56 (1.96, 3.35)], then Group C [AOR 2.44 (1.87, 3.18)].ConclusionReminders/SMS immunization facts improve vaccination completion rates.     

War-related trauma exposure and multiple risk behaviors among school-going adolescents in Northern Uganda: The mediating role of depression symptoms

Background

The relationship between war-related trauma exposure, depressive symptoms and multiple risk behaviors among adolescents is less clear in sub-Saharan Africa.

Methods

We analyzed data collected from a sample of school-going adolescents four years postwar. Participants completed interviews assessing various risk behaviors defined by the Youth Self Report (YSR) and a sexual risk behavior survey, and were screened for post-traumatic stress, anxiety and depression symptoms based on the Impact of Events Scale Revised (IESR) and Hopkins Symptom Checklist for Adolescents (HSCL-37A) respectively. Multivariate logistic regression was used to assess factors independently associated with multiple risk behaviors. The logistic regression model of Baron and Kenny (1986) was used to evaluate the mediating role of depression in the relationship between stressful war events and multiple risk behaviors.

Results

Of 551 participants, 139 (25%) reported multiple (three or more) risk behaviors in the past year. In the multivariate analyses, depression symptoms remained uniquely associated with multiple risk behavior after adjusting for potential confounders including socio-demographic characteristics, war-related trauma exposure variables, anxiety and post-traumatic stress symptoms. In mediation analysis, depression symptoms mediated the associations between stressful war events and multiple risk behaviors.

Limitations

The psychometric properties of the questionnaires used in this study are not well established in war affected African samples thus ethno cultural variation may decrease the validity of our measures.

Conclusions

Adolescents with depression may be at a greater risk of increased engagement in multiple risk behaviors. Culturally sensitive and integrated interventions to treat and prevent depression among adolescents in post-conflict settings are urgently needed.     

Effect of sex steroids on the reproductive behavior of castrated male ring doves (Streptopelia sp.)

Castrated male ring doves were injected with 100 μg/day testosterone propionate (TP), estradiol benzoate (EB), or dihydrotestosterone propionate (DHTP) for two weeks and then tested for sexual and aggressive behavior with female partners. TP restored bow-cooing, hop-charging, wing-flipping, and copulation to levels of intact males. EB stimulated a great deal of wing-flipping, but little other behavior. DHTP stimulated some bow-cooing and hop-charging, but little wing-flipping or copulation. In a second experiment, DHTP again activated bow-cooing and hop-charging, but DHT (the free alcohol form of this steroid) was without significant effect. Thus, DHTP is behaviorally effective in this species, “aggressive” courtship and “nest-oriented” courtship have different patterns of steroid specificity, and wing-flipping in intact males may result from conversion of androgen to estrogen by the brain.     

Relationship of blood pressure status,dietary factors and serum electrolytes of in-school adolescents in Ilishan-Remo,Ogun State,Nigeria

BackgroundGlobally, rising blood pressure is of public health concern as it is a major cause of cardiovascular diseases (CVDs), and preventable death. This study accessed the relationship of blood pressure status, dietary factors and serum electrolytes among in-school adolescents in Ilishan-Remo, Ogun State, Nigeria.MethodsA cross-sectional survey of 488 secondary school students (aged 10–19 years). Blood pressures were assessed using auscultatory method and questionnaires were used to obtain food frequency and 24-hour dietary recall data. Blood samples from volunteers were used for serum sodium and potassium assays.ResultsThe mean systolic blood pressure (SBP) increased with age, irrespective of gender. The prevalence of elevated blood pressure and hypertension among participants were 19.3% and 10.5%, respectively, with males and females having similar pattern. Dietary factors like addition of table salt to already prepared foods, higher intake of eggs, and lower intake of vegetables were associated with the development of elevated blood pressure among the adolescents. The estimated mean dietary intakes (mg/person/day) of sodium and potassium were 2289±938.7 and 1321±603.8, respectively, with majority consuming far higher (for sodium – 80%) or far below (for potassium – 95%) recommendations. The mean serum sodium (138.0±18.3 mmolL^-1) and potassium (3.06±1.1 mmolL^-1) were similar across genders. A significant (p<0.05) negative relationship exists between serum potassium and SBP.ConclusionsThe blood pressure status of the adolescents studied are of great concern and are somewhat negatively influenced by poor dietary and lifestyle practices. They require prompt intervention to slow down the development of CVDs in the future.     

Sexual behaviour and Chlamydia trachomatis infections in German female urban adolescents, 2004

This ad-hoc observational study, conducted in the metropolitan area of Berlin during 2004, revealed that the prevalence of Chlamydia trachomatis (CT) infections in female urban adolescents self-presenting at their gynaecologist without (n=397) or with (n=124) symptoms of CT infection was 5.5% (95% CI 3.7-8.2%) and 9.7% (95% CI 5.6-16.2%), respectively. The prevalence of CT infection was significantly dependent on the number of lifetime sexual partners. Condom use was inconsistent, and lack of knowledge about CT infections and associated health risks predominated in this cohort. The data indicated a need for health education concerning CT to be targeted at female adolescents.     

Studies on the sexual behaviour, haematology and spermatogenesis of male rabbits infected with Trypanosoma brucei brucei

A total of 24 crossbreed buck rabbits (New Zealand White × chinchilla) were used to evaluate the effect of experimental infection with Trypanosoma brucei on symptoms, sexual behaviours, haematology and spermatogenesis. The rabbits were divided into two groups (A and B) of 12 rabbits each. Group A rabbits were infected with 1.25 × 10⁶ of T. brucei, whereas group B served as the uninfected control. The trypanosomes were detectable in the blood of all the infected bucks by day 7 post-infection (PI) with mean pre-patent period of 4.7 ± 0.85 days. The red blood cell (RBC) and packed cell volume (PCV) decreased significantly (P < 0.05) from day 8 to 28 PI. The values however improved from day 36 PI and were similar to the uninfected control. The reverse was the case of parasitaemia. Two rats died at the peak of the decrease in RBC and PCV and increase in parasitaemia. There was also significant (P < 0.05) loss in live and testis weights, reduced libido and impaired spermatogenesis in the infected group. The infected bucks showed clinical signs similar to that reported in other trypanosome-infected animals. It is concluded that susceptibility of crossbreed rabbits usually kept in Africa to pathogenic trypanosomes is characterised by an acute stage manifested by anaemia, high parasitaemia and death and chronic stage manifested by improved PCV and RBC, very low parasitaemia but high tissue damage and low productivity. Control of this disease in endemic areas for purpose of commercial rabbit production is advocated.     

Self-reported sexual behaviour among adolescent girls in Uganda: reliability of data debated

Objective

To compare self-reported information about sexual behaviour in a research interview to information retrieved during a clinical consultation.

Method

595 sexually experienced women below 20 years, were interviewed by a social worker about genital symptoms and sexual behaviour. A midwife interviewed, examined, and took vaginal samples for gonorrhoea and chlamydia. Four questions were embedded in both the social workers interviews and among midwife''s questions. The women were asked if they perceived their latest /current partner to be faithful, if he had complained about any genital symptoms, if a condom was used at latest sexual intercourse and if the woman knew her HIV status.

Results

The prevalence of gonorrhoea and/or chlamydia was 7.1% but for women who reported that their partner had complained about genital symptoms it was significantly higher. Agreement between answers given in the research interview and to the midwife was good for HIV status but only fair or moderate for perceived faithfulness, partner''s symptoms and recent condom use.

Conclusion

Information about risk factors revealed in individual interviews and by the midwives taking a history was incongruent. Any approach for management of STIs, which is built on self-reported risk factors, needs careful assessment of reliability.     

Effects of early sex steroid hormone treatment on courtship behavior and sexual attractivity in the red-sided garter snake, Thamnophis sirtalis parietalis

Previous research has shown that exogenous androgen fails to elicit courtship (chin-rubbing) behavior in adult male or female red-sided garter snakes (Thamnophis sirtalis parietalis). However, gonadectomized and intact newborn male and female red-sided garter snakes given silastic capsules containing testosterone exhibit chin-rubbing behavior; gonadectomized and untreated animals do not show this behavior. Both males and females also exhibit chin-rubbing behavior when treated with testosterone as yearlings. Hibernation stimulates chin-rubbing behavior only in males that have received androgen treatment as a neonate or as a yearling. Previous research has also shown that adult females, but not adult males, are courted if given estrogen treatment. Both newborn males and females will elicit chin-rubbing behavior from adult males if given estrogen treatment, indicating production and release of an attractiveness pheromone characteristic of adult females. Male red-sided garter snake breed for the first time on emergence from their second hibernation, whereas females probably do not breed until their third year of life. These data suggest that in the red-sided garter snake, a species that exhibits a dissociated reproductive tactic, sex steroid hormones act to organize central nervous system mechanisms subserving courtship behavior such that temperature, and not hormonal, fluctuations activate sexual behavior in the adult organism.     

The peak oxygen uptake of British children with reference to age,sex and sexual maturity

Summary The purposes of this study were to provide baseline data on the peak oxygen consumption (VO₂) of British children, aged 11–16 years and to examine the peakVO₂ of children in relation to their pubertal stage of development. The peakVO₂ of 226 boys and 194 girls was determined during either treadmill running or cycle ergometry. The sexual maturity of 320 of the children was estimated using Tanner's indices. PeakVO₂ increased with chronological age in both sexes and from about the age of 12 years boys exhibited significantly higher (P<0.05) values than girls. Boys' peakVO₂ in relation to body mass was consistent over the age range studied and was superior (P<0.05) to girls' values at all ages. It appears that mass-related peakVO₂ is independent of sexual maturity in both sexes. The more mature boys demonstrated a significantly higher (P<0.05) peakVO₂ (l·min^–1) than the less mature boys on both ergometers. The more mature girls demonstrated significantly higher (P<0.05) peakVO₂ (l·min^–1) than the less mature girls only on the cycle ergometer. On both ergometers the differences between the peakVO₂ of the girls and boys were more pronounced in the mature children whether expressed in relation to body mass or not. Comparison of the results with earlier data drawn from smaller samples failed to provide evidence to suggest that British children's peakVO₂ has declined in recent years. No study with which to compare our maturity peakVO₂ data appears to be available.     

Neonatal gonadal hormones: Effect on maternal and sexual behavior in the female rat

It has been found that significant differences exist between male and female rats of the Long-Evans strain on maternal behavior when the animals were presented with rat pups for seven consecutive days. The presence of ovarian or testicular products at the time of maternal testing did not have a facilitating or suppressing effect on maternal behavior in the Long-Evans rat. Females given 100 μg or 1 mg of testosterone propionate (TP) four days after birth and gonadectomized at 25 days of age behaved like control females (oil injected four days after birth and gonadectomized at 25 days of age) on measures of maternal behavior, but showed significantly lower sexual receptivity when primed with estrogen and progesterone. Thus the female sexual behavior system was suppressed by neonatal TP, but the maternal mediating system was not suppressed by the same treatment. It is concluded that the critical periods of differentiation may be different for sex and maternal behavior.