>Modern Contraception: Uptake and Correlates among Women of Reproductive Age-Group in a Rural Community of Osun State,Nigeria

BackgroundUniversal contraceptive access is one of the key strategies for achieving sustainable developments in any country. Yet, uptake has remained low in most developing nations like Nigeria. The reasons for low use must be contextually understood to aid effective contraceptive programming. This study assessed contraceptive use and its determinants among reproductive aged women in Ejigbo, Osun State, Nigeria.MethodsA quantitative study involving 405 participants which were recruited using multi-stage sampling method was carried out. Data were collected using pretested semi-structured, interviewer-administered questionnaire. Chi-Square test and binary logistic regression analysis were used for inferential statistics.ResultThe mean age of the respondents was 28±6. The majority (92.8%) of the respondents were aware of family planning, 68.9% of them possessed good knowledge but only 53% of them demonstrated favorable contraceptive attitude. Less than half (33.0%) of those who had heard about contraception were current users of modern methods. Injectables (45.0%) and male condoms (30.0%) were the most prevalent contraceptive methods among the respondents. The main determinants of contraceptive uptake were respondents’ educational status (AOR=0.525, 95%CI=0.284-0.972), contraceptive knowledge (OR=0.512, 95%CI=1.242-1.968) and attitude (OR=0.512, 95%CI=1.2421.968). Fear of perceived side effects (45.2%), low pregnancy risk perception (35.7%) and spousal refusal (12.5%) were the main reasons for non-contraceptive use among non-users.ConclusionContraceptive demand in the study population was low in spite of high awareness level. There is a need to increase contraceptive literacy in the study population and make the services more acceptable to rural dwellers so as to meet the SDG-3 target in Nigeria.     

Outcomes of a home cycling program using functional electrical stimulation or passive motion for children with spinal cord injury: a case series

BACKGROUND/OBJECTIVE: Children with spinal cord injury (SCI) are at risk for musculoskeletal and cardiovascular complications. Stationary cycling using functional electrical stimulation (FES) or passive motion has been suggested to address these complications. The purpose of this case series is to report the outcomes of a 6-month at-home cycling program for 4 children with SCI. METHODS: Two children cycled with FES and 2 cycled passively at home for 1 hour, 3 times per week. OUTCOME MEASURES: Data collected included bone mineral density of the left femoral neck, distal femur, and proximal tibia; quadriceps and hamstring muscle volume; stimulated quadriceps and hamstring muscle strength; a fasting lipid profile; and heart rate and oxygen consumption during incremental upper extremity ergometry testing. RESULTS: The 2 children cycling with FES and 1 child cycling passively exhibited improved bone mineral density, muscle volume, stimulated quadriceps strength, and lower resting heart rate. For the second child cycling passively, few changes were realized. Overall, the lipid results were inconsistent, with some positive and some negative changes seen. CONCLUSIONS: This case series suggests that cycling with or without FES may have positive health benefits and was a practical home exercise option for these children with SCI.     

Preliminary report of experience with gynaecologic laparoscopy in Ogbomoso,Nigeria

Gynaecologic laparoscopy (GL) had remained in latency in Nigeria because of widespread lack of equipment and skilled personnel. This study presents a pioneer experience with laparoscopic procedures in Gynaecological unit of the Bowen University Teaching Hospital (BUTH), Ogbomoso, Nigeria. Consecutive patients who had laparoscopic procedures from May 2014 to April 2015 were prospectively studied. There were 52 GLs, making up 28.1 % of the 185 gynaecologic surgeries over the study period. The patients’ ages ranged from 18 to 50 years (mean age?=?32.6?±?6.0 years). Eighteen (34.6 %) of the GLs were emergencies, whereas 34 (63.4 %) were elective. Fifteen patients (28.8 %) had only diagnostic laparoscopy for various gynaecological conditions. Eight patients (15.4 %) had tubal surgery for tubal factor infertility. Two patients (3.9 %) had bilateral tubal occlusion as permanent method of contraception. There were 6 salpingectomies for ectopic pregnancy (11.5 %) and three (5.8 %) excision of endometriosis nodules. Nine (28.9 %) ovarian cystectomies and 6 (11.5 %) laparoscopic adhesiolysis were also performed. There were 2 (3.8 %) laparoscopic ovarian drilling for polycystic ovary syndrome and 1 (1.9 %) laparoscopic retrieval of a translocated IUCD. The duration of surgery ranged from 45 to 150 min (mean time?=?76.6?±?32.55 min). Various improvisations and local adaptations were necessary in the course of 14 procedures (27.5 %). There were 2 conversions to laparotomy (3.8 %), all following emergency laparoscopy. There was no major complication despite the challenging intraoperative adverse conditions. The duration of hospital stay postoperatively ranged from 4 h to 4 days (median time?=?11 h). There was no mortality. On the basis of our experience, we are of the opinion that gynaecologic laparoscopy procedures can be performed routinely in Nigerian hospitals with acceptable outcome. We advocate the local adaptation of equipments in our environment to ensure sustainability.     

Orthopoxvirus Infections in Rodents,Nigeria, 2018–2019

To investigate animal reservoirs of monkeypox virus in Nigeria, we sampled 240 rodents during 2018–2019. Molecular (real-time PCR) and serologic (IgM) evidence indicated orthopoxvirus infections, but presence of monkeypox virus was not confirmed. These results can be used to develop public health interventions to reduce human infection with orthopoxviruses.     

Explanatory model of psychosis: impact on perception of self-stigma by patients in three sub-saharan African cities

Background

Most cultures in sub-Saharan Africa subscribe to the belief that the root cause of psychosis is supernatural. Individuals in the community who hold a religiomagical explanatory model of causation have been shown to exhibit more stigmatizing attitudes towards people with psychosis. Self-stigma among individuals with psychosis is less frequently studied.

Method

We used a mixed-method approach, consisting of key informant’s interviews to elicit information on explanatory models of causation of psychosis and questionnaire assessment of internalized stigma with an adapted version of the Scale for Internalized Stigma of Mental Illness. Twenty-four, 31, and 30 subjects with recent experience of utilizing the service of traditional or faith healers for severe mental disorders in Ibadan (Nigeria), Kumasi (Ghana), and Nairobi (Kenya), respectively, were interviewed.

Results

About 44 % (42.1 %) of the Nigerian respondents had a high (severe) level of self-stigma with the respective proportions among Ghanaian and Kenyan respondents being 20.7 and 37.5 %. Compared with 4 out of a total of 12 respondents (33.3 %) who reported low self-stigma reported supernatural attribution, 14 out of 20 respondents (70 %) with the highest level of self-stigma reported supernatural attribution across the three sites. When low scorers ascribed supernatural causation, it was often with a religious focus.

Conclusion

There is a greater tendency for persons with high levels of self-stigma than those with low levels to ascribe supernatural attribution to their experience of a severe mental health condition.

     

Microcirculation on a large scale: techniques, tactics and relevance of studying the microcirculation in larger population samples

The role of microcirculatory dysfunction is increasingly being recognized in the etiopathogenesis of cardiovascular disease. Whilst the importance of detailed mechanistic studies to determine the exact nature of these disturbances is without question, it was large-scale population-based studies that first identified the associations between deranged microvascular perfusion, autoregulation or structure, and subsequent target organ damage. This is the subject of considerable studies to establish whether there is a causal effect in either direction, or simply represents shared risk factors, although it is most likely to be a complex combination of bidirectional interactions. The techniques for investigating microcirculatory function have evolved almost exponentially over the last 75 years: So too have the strategies for investigation. Current epidemiological studies are focusing on attempting to untangle the inter-relationship between risk factors and pathological mechanisms to attempt to determine whether these represent therapeutic targets or simple markers of unmeasured risk. We plan to review the techniques used for these population-based studies, the advances made, and the clinical implications derived.     

Determinants of transition across the spectrum of alcohol use and misuse in Nigeria

Many studies have examined the risk factors associated with alcohol use disorders. No information is available from developing countries about the factors that may determine the transitions across different levels of use and misuse. Alcohol use and its misuse were assessed in a cohort of 2143 Nigerians using Version 3.0 of the World Health Organization Composite International Diagnostic Interview (WHO-CIDI). This generated six levels of alcohol use and related disorders. Using age of onset variables created for the purpose, analysis was done to determine rates of and risk factor for transition between the levels. Lifetime prevalence estimates were 57.8% for alcohol use, 27.6% for regular use, 2.9% for abuse, and 0.3% for dependence. Whereas 47.8% transited to regular use from lifetime ever use, only 10.5% transited to abuse from regular use and 9.5% from abuse to dependence. Male sex, age 18–49 years and being never married predicted onset of alcohol use. Transition to regular use was predicted only by male sex while transition to abuse was predicted by male sex and age 35–49 years. Factors associated with recovery from abuse were female sex and a student status. Higher rates of transition occurred in the stages preceding the onset of alcohol use disorders. Sex and age were the main determinants of transition, with male gender and middle age being risk factors for transition to problematic use of alcohol.