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Principles and methods of validity and reliability testing of questionnaires used in social and health science researches
Oladimeji Akeem Bolarinwa
October-December 2015, 22(4):195-201
DOI:10.4103/1117-1936.173959  PMID:26776330
The importance of measuring the accuracy and consistency of research instruments (especially questionnaires) known as validity and reliability, respectively, have been documented in several studies, but their measure is not commonly carried out among health and social science researchers in developing countries. This has been linked to the dearth of knowledge of these tests. This is a review article which comprehensively explores and describes the validity and reliability of a research instrument (with special reference to questionnaire). It further discusses various forms of validity and reliability tests with concise examples and finally explains various methods of analysing these tests with scientific principles guiding such analysis.
  356,562 29,265 141
A review of the health problems of the internally displaced persons in Africa
Eme T Owoaje, Obioma C Uchendu, Tumininu O Ajayi, Eniola O Cadmus
October-December 2016, 23(4):161-171
DOI:10.4103/1117-1936.196242  PMID:28000636
Globally, over 40 million people were displaced as a result of wars and violence due to religious and ethnic conflicts in 2015 while 19.2 million were displaced by natural disasters such as famine and floods. In Africa, 12 million people were displaced by armed conflict and violence and there were hundreds of thousands of people displaced by natural disasters. Despite these large numbers of internally displaced persons (IDPs) in Sub-Saharan African countries and the potentially negative impact of displacement on the health of these populations, there is limited information on the health problems of IDPs in the region. The previous studies have mainly focused on the health problems of refugees and single disease entities among IDPs. However, a more comprehensive picture is required to inform the provision of adequate healthcare services for this vulnerable population. The objective of this review was to fill this knowledge gap. Bibliographic databases were searched and screened, and nine studies were selected and reviewed. The major physical health problems and symptoms were fever/malaria (85% in children and 48% in adults), malnutrition in children (stunting 52% and wasting 6%), malnutrition in adult males (24%), diarrhoea (62% in children and 22% in adults) and acute respiratory infections (45%). The prevalent mental health problems were post-traumatic stress disorder (range: 42%-54%) and depression (31%-67%). Most of the studies reviewed focused on mental health problems. Limited evidence suggests that IDPs experience various health problems but more research is required to inform the provision of adequate and comprehensive healthcare services for this group of individuals.
  27,783 2,471 14
Neonatal Jaundice: Knowledge, Attitude and practices of mothers in Mosan-Okunola community, Lagos, Nigeria
Olayinka O Goodman, Omolara A Kehinde, Babatunde A Odugbemi, Toriola T Femi-Adebayo, Olumuyiwa O Odusanya
July-September 2015, 22(3):158-163
DOI:10.4103/1117-1936.170741  PMID:26739202
Background: A community-based survey was conducted amongst mothers aged 15–49 years living in Mosan-Okunola, Lagos, Nigeria to determine the knowledge of, attitudes to, preventive and treatment practices towards neonatal jaundice (NNJ). Materials and Methods: The mothers were selected using a multi-stage sampling technique. A pre-tested interviewer-administered structured questionnaire was used to obtain data. The knowledge of the mothers was scored and scores lower than 50% were graded as poor, 50–74% as fair and ≥75% as good. The practice was also categorised as appropriate if one correct option was identified and was categorised as inappropriate where an incorrect option(s) was identified singly or in combination with a correct option. Results: Three hundred and fifty-eight mothers were recruited. The mean age was 34.8 ± 9.05 years. Two hundred and seventy (75.4%) mothers had ever heard about the condition. Two hundred and forty-seven (91.4%) mothers correctly identified the condition and infection was the only most common known cause (47%). Only 34% of the mothers knew that NNJ could cause brain damage, and 40% identified refusal of feeds as a danger sign. Up to 64% of the mothers believed attending antenatal care could prevent the condition, and 58% were of the opinion that exposing babies to sunlight could prevent the condition. Sixty-eight percent (68.9%) of the mothers had a poor level of knowledge. Age and educational qualification did not show any statistically significant relationship with knowledge about NNJ (P < 0.05) but increasing maternal age had a significant association with an appropriate treatment practice (P < 0.05), the association was negative (r = −0.32). Conclusion: Knowledge about NNJ was low in this community and ineffective preventive practices were utilised. Efforts should be made to increase it, and health workers should play a leading role.
  14,485 1,407 7
Clinical and doppler ultrasound evaluation of peripheral arterial diseases in Kano, North-western Nigeria
Anas Ismail, Muhammad Kabir Saleh, Abdulkadir Musa Tabari, Kabiru Isyaku
October-December 2015, 22(4):217-222
DOI:10.4103/1117-1936.173971  PMID:26776334
Aims and Objectives: Doppler ultrasound scan is a non-invasive and cheap tool that complements the roles of computed tomography, magnetic resonance imaging and catheter digital subtraction angiography in the screening, diagnosis and follow up of vascular diseases. In this study, we evaluated and described the findings of the Doppler ultrasound of the peripheral arteries performed at Aminu Kano Teaching Hospital (AKTH), Kano, Nigeria. Patients and Methods: All the findings of peripheral arterial Doppler ultrasound examinations performed at AKTH during a period of 18 months (from February 2012 to July 2013) were reviewed. All examinations were done using 7.5 MHz linear transducer connected to Mindary Digital Ultrasound Imaging System (Model DC-6; Shenzhen Mindray Biomed Electronics, Shenzhen, China). A 3.5 MHz convex transducer of the same machine was used in obese patients and those with severe subcutaneous oedema. Results: The findings of 50 males and 28 females were reviewed. Their mean age was 55.8 ΁ 17.9 years. Diabetic foot disease, intermittent claudication, gangrene and limb swellings were the most common indications for arterial Doppler examination of the lower limbs, constituting 32.1%, 20.5%, 16.7% and 15.4%, respectively. Significant luminal stenosis, total luminal occlusion and loss of arterial resistance were the most frequent findings, constituting 29%, 26.9% and 7.7%, respectively. Femoro-popliteal and below the knee arteries were commonly involved by these abnormalities. Arrhythmia, increased intimal media thickness and wall calcifications were the common compounding findings while diabetes and hypertension were frequently associated clinical problems of these patients. Conclusion: Doppler ultrasound has a high diagnostic yield in depicting abnormalities in patients with clinical features of peripheral arterial disease.
  14,520 858 -
Experience and knowledge of child abuse and neglect: A survey among a group of resident doctors in Nigeria
Olubukola Olamide Olatosi, Philip U Ogordi, Folakemi A Oredugba, Elizabeth O Sote
October-December 2018, 25(4):225-233
DOI:10.4103/npmj.npmj_92_18  PMID:30588943
Background: Child abuse and neglect (CAN) is a significant public health problem. Dentists are in good position to identify and report cases of CAN. Aim: The aim of this study was to determine the experience and knowledge of CAN among a group of Nigerian dental residents. Materials and Methods: This was a cross-sectional study carried out among dentists attending a postgraduate update course. Data were collected to assess the knowledge of respondents on the forms of CAN, indicators and risk factors. Respondents' professional experiences were also assessed as well as actions taken and possible barriers to reporting suspected cases. Results: Data were collected from 179 respondents, with a mean age of 33.1 ± 5.2 years. The respondents demonstrated good knowledge of the forms of child abuse, with an average score of 95.2%. The risk factors for CAN were correctly identified by 153 (85.5%) respondents as children with physical/mental disabilities, 151 (84.4%) as products of unwanted pregnancies, 128 (71.5%) as children from polygamous families and 122 (68.2%) as children from low socioeconomic families. Physical, sexual and emotional abuse and neglect were majorly identified as bruises behind the ears, 162 (90.5%); oral warts, 114 (63.7%); poor self-esteem, 158 (88.3%) and untreated rampant caries, 137 (76.5%), respectively. Seventy-four (46.5%) of the respondents did not evaluate children for CAN and only 12 (14.1%) of those who observed suspected cases of CAN reported to the social service. Lack of knowledge of referral procedures and concerns about confidentiality were the major barriers to reporting cases of CAN. Conclusion: The dentists had good theoretical knowledge of the indicators, risk factors and signs of CAN but lagged in clinical detection and reporting of such suspected cases. There is a need for continuing education and advancement of the postgraduate dental curriculum to improve the educational experiences with regard to CAN.
  10,301 730 1
Knowledge of occupational hazards among sawmill workers in Kwara state, Nigeria
Busayo Emmanuel Agbana, Alabi Oladele Joshua, Moses A Daikwo, Loveth Olufunto Metiboba
January-March 2016, 23(1):25-32
DOI:10.4103/1117-1936.180176  PMID:27098946
Background: This study was aimed at assessing the knowledge of sawmill workers on occupational hazards in Kwara State. Subjects and Methods: It was a cross-sectional analytical study using a multi-stage sampling technique to recruit sawmill workers into the study group in Kwara State. One hundred and ninety-six workers who had been in continuous employment in sawmill factories for a minimum of 6 months were studied. Semi-structured questionnaire adapted from British Medical Council questionnaire on occupational hazards was used for data collection. A 15-point scale was used to assess knowledge of respondents by awarding 1 and 0 point to correct and wrong responses, respectively. Respondents with total score of >5, 5-7 and >7 were classified as having poor, fair and good knowledge of occupational hazards. The data generated were entered and analysed using SPSS version 16 computer software. A P > 0.05 was considered to be statistically significant at 95% confidence level for the study. Results: The knowledge of sawmill workers on occupational hazards was low, 61.7% of the respondents had poor knowledge, whereas 15.8% had good knowledge. Half of the respondents knew that exposure to hazards could be reduced by limiting their work hours to a maximum of 8 hours per day. More than three-quarters had experienced noise, closely followed by heat and injuries among the study group. Conclusion: Sawmill workers experience various work-related hazards and health problems. This study revealed the need for an increased knowledge on occupational hazards and its prevention among sawmill workers in Kwara State.
  8,833 847 -
The health of internally displaced persons
Olumuyiwa Omotola Odusanya
October-December 2016, 23(4):159-160
DOI:10.4103/1117-1936.196241  PMID:28000635
  6,979 1,559 -
Comparison of patient satisfaction with acrylic and flexible partial dentures
Clara Arianta Akinyamoju, Tunde Joshua Ogunrinde, Juliana Obontu Taiwo, Oluwole Oyekunle Dosumu
July-September 2017, 24(3):143-149
DOI:10.4103/npmj.npmj_54_17  PMID:29082902
Purpose: Restoration of partial edentulous mouth may be done using a variety of treatment options. Removable partial denture (RPD) is commonly used because of its availability. RPDs from flexible resins unlike those from acrylic engage hard and soft tissue undercuts and feel more comfortable in the mouth. The aim of the study was to compare satisfaction with dentures made from these two types of materials. Materials and Methods: It was a quasi-experimental study among thirty patients at the Prosthetics Clinic, University College Hospital, Ibadan. Patients aged 16 years or more, requiring RPDs with one to three missing teeth in the anterior region of either the upper or lower arch participated. A modified semi-structured interviewer-administered questionnaire was used to collect data on sociodemographics and oral health variables. The level of satisfaction was assessed using a visual analogue scale. Data were analysed using descriptive and multivariate statistics at a significance level of P < 0.05. Results: The participants' ages ranged between 16 and 51 years, mean age was 33.8 ± 10.01 years. Male: female ratio was 1:1 and mean duration of edentulousness was 11.37 ± 10.52 years (median - 9.50). Most 28 (93.3%) subjects delayed replacement of their missing teeth; reasons were indifference 13 (43.4%), financial constraint 10 (33.3%), ignorance 4 (13.3%) and fear of aspiration 1 (3.3%). Overall, 21 (70.0%) participants were more satisfied with the flexible dentures, 6 (20.0%) with acrylic dentures while 3 (10.0%) were equally satisfied with both types of dentures (P = 0.04). Conclusion: Subjects were more satisfied with the flexible RPD than the acrylic resin RPD.
  7,273 1,098 2
Factors influencing the use of malaria prevention methods among women of reproductive age in peri-urban communities of Port harcourt city, Nigeria
Charles Ibiene Tobin-West, Esther Njideka Kanu
January-March 2016, 23(1):6-11
DOI:10.4103/1117-1936.180114  PMID:27098942
Background: Malaria remains a huge national concern in Nigeria with severe implications for maternal and child health. Aims: This study was aimed at investigating factors that influence malaria prevention among women of reproductive age in line with the National Malaria Control objectives. Subjects and Methods: A descriptive, cross-sectional study design and cluster sampling technique was used to recruit study participants. Respondents had 'correct' knowledge of malaria if they knew the cause and symptoms of malaria. Otherwise is classified as 'incorrect'. Data were analysed in Epi Info version 7 with the level of statistical significance set at P 0≤ 0.05. Results: Most respondents, 709 (89%) had good knowledge of malaria. Their educational level was significantly associated with this knowledge (χ2 = 3.6993, P = 0.0544). There were, however, some myths and misconceptions about malaria. Of 390 (49.3%) that owned insecticide treated bed nets (ITNs), only 59 (18.2%) used them consistently, while only 31 (50%) of the pregnant women received intermittent preventive treatment (IPTp). Malaria knowledge, ITNs ownership and female education were not significantly associated with ITN and IPTp usage. Married women had 3 times higher odds of ITN usage than the unmarried, (odds ratio [OR] = 2.69, 95% confidence interval [95% CI] = 1.56-4.62), and women with children had 2 times higher odds of usage than those without (OR = 2.42, 95% CI = 1.42-4.12). Conclusions: The use of malaria prevention measures among women of reproductive age is still sub-optimal. We advocate for intensified education of women on malaria in local languages, using role plays and community dialogues. Efforts must also be directed at dispelling myths and misconceptions about malaria for maximum impact.
  7,594 667 6
Pathogenesis, diagnostic challenges and treatment of zika virus disease in resource-limited settings
Nathan Yakubu Shehu, David Shwe, Kenneth I Onyedibe, Victor C Pam, Ibrahim Abok, Samson E Isa, Daniel Z Egah
April-June 2018, 25(2):67-72
DOI:10.4103/npmj.npmj_36_18  PMID:30027916
The association of Zika virus (ZIKV) infection with congenital malformation and neurological sequelae has brought significant global concern. Consequently, the World Health Organization (WHO) declared it “a public health emergency of International concern” on 1 February, 2016. A critical review of its pathogenesis would lead to a better understanding of the clinical features and the neurological complications. This review is based on literature search in PubMed/Medline, Google Scholar and the WHO, http://www.who.int. This include all relevant articles written in English published through June 2018, with subject heading and keywords such as Zika, ZIKV, Zika pathogenesis, diagnosis of Zika, Zika Nigeria, Zika Africa and Zika resource-limited settings. Following ZIKV infection, viraemia ensues targeting primarily the monocytes for both the Asian and African strains. ZIKV infection by an African strain appears to be more pathogenic, in early pregnancy tends to result in spontaneous abortion. Whereas an Asian strain tends to be less pathogenic and more chronic, this allows the pregnancy to continue, ultimately resulting in congenital malformations. There is no routine laboratory diagnosis of ZIKV infection in resource-constrained countries. Serologic tests should be interpreted with caution since there can be cross-reactivity with other flaviviruses, especially in Africa where the burden of infection with flaviviruses is comparatively high. There is a paucity of well-equipped laboratories for comprehensive ZIKV diagnosis. It is imperative to strengthen the health systems, improve health workforce and diagnostic capacity of such settings.
  6,842 699 2
Femoral neck shaft angles: A radiological anthropometry study
Thomas Oduntan Adekoya-Cole, Olasode Israel Akinmokun, Kofoworola O Soyebi, Omachoko Emmanuel Oguche
January-March 2016, 23(1):17-20
DOI:10.4103/1117-1936.180130  PMID:27098944
Background: Most of the available orthopaedic implants were designed and manufactured based on data from Western population whose skeletal dimensions are different from those of Africans. Objectives: This study was conducted to determine the value of the neck-shaft angle (NSA) of Nigerians living in Lagos for the purpose of adequate planning, preparation, and pre-operative selection of orthopaedic implants for surgeries involving the femoral neck and stocking of orthopaedic implants in hospitals located in resource poor countries like Nigeria. Materials and Methods: This was a retrospective study which involved measuring the NSAs of anterior-posterior views of pelvic radiographs of adult patients reported "normal study" by the radiologist. Results: A total of 264 femoral necks were analysed from 132 patients' radiographs comprising of 68 males and 64 females. The average NSA for an adult Nigerian living in Lagos is 130.77° ± 6.03° with mean NSA value of 131.28° ± 6.56° for the right and 130.22° ± 5.18° for the left. The mean value of NSA for an adult male is 131.57° ± 5.66° whereas the mean value for an adult female is 129.97° ± 6.33°. Conclusion: The value of NSA obtained from this study should be considered during the surgical fixation of the neck of femur fractures or osteotomies around the neck of the femur of adult Nigerians. It should also be noted during designing and bioengineering construction of orthopaedic implants and hip prosthesis for Nigerians.
  6,939 597 1
Sonographic evaluation of axillary lymph nodes in women with newly diagnosed breast cancer at the university college hospital Ibadan, Nigeria
Atiku Hafiz, Adenike Temitayo Adeniji-Sofoluwe, Adeyinka Francis Ademola, Millicent Olubunmi Obajimi
April-June 2018, 25(2):79-86
DOI:10.4103/npmj.npmj_74_18  PMID:30027918
Background: Axillary lymph node (LN) status of patients with breast cancer is important in the surgical management. Sonographic evaluation of axillary LNs in newly diagnosed breast cancer is required to predict prognosis. Objective: The purpose of this study was to describe the morphologic features by sonographic evaluation of the cortices and sinuses as well as patterns of blood flow of axillary LNs and correlate same with the clinical staging in women with newly diagnosed breast cancer in a tertiary referral centre. Patients and Methods: This was a prospective and descriptive study of 106 newly diagnosed female breast cancer patients recruited from the surgical outpatient clinic of the University College Hospital, Ibadan, during a period of 9 months in 2015. All 106 patients had clinical evaluation, sociodemographic documentation and ultrasound scans of the breast and axillae performed. Results: The mean age of patients was 48.1 (±11.1) years with age range 20–82 years. Most patients have a negative family history of breast cancer as seen in 97 (91.4%) of them. Abnormal cortex-hilum area ratio was more frequent in the right (66.7%) than the left (41.2%) axillary LNs. Longitudinal-transverse ratio was abnormal in 93.5% and 86.3% of LNs in the right and left axillae, respectively. Slit-like hilum, eccentric cortical thickening, replaced node and rat-bite appearance, respectively, were found in 40.7%, 10.4%, 48.4% and 44.4% of LNs in the right axilla. The peripheral flow type was demonstrated in 46.8% and 48.1% of LNs in the right and left axillae, respectively. Conclusion: Ultrasonography is a good diagnostic tool that can be employed with reasonable accuracy in the initial assessment of axillary involvement in breast cancer. Although the assessment of tumour size and clinical staging leaves little doubt as to the stage of breast cancer disease, sonographic evaluation of the breast and the axilla painted a more ominous picture.
  6,384 367 1
Prevalence of Vitamin A deficiency among under-five children in South-Western Nigeria
Olufunmilola O Abolurin, Adebanjo J Adegbola, Oyeku A Oyelami, Samuel A Adegoke, Oluseye O Bolaji
January-March 2018, 25(1):13-16
DOI:10.4103/npmj.npmj_20_18  PMID:29676339
Background and Aim: Vitamin A deficiency (VAD) constitutes a major nutritional concern in developing countries. It contributes significantly to the morbidity and mortality of under-five children and can result in impaired resistance to infection as well as increased risk of death. The aim of this study was to determine the prevalence of VAD among Southwestern Nigerian children. Methods: Apparently healthy children aged between 6 months and 5 years were recruited for the study. Their serum retinol levels were determined by high-performance liquid chromatography. Results: Of the 170 children studied, nine (5.3%) had VAD, although none had severe VAD. The prevalence of VAD did not show statistically significant variation with age (P = 0.159), sex (P = 1.000), social class (P = 0.740), immunisation status (P = 0.197) or nutritional status (P = 0.090). Conclusion: The prevalence of VAD among Nigerian children appears to have reduced, compared with previous reports; however, further studies are required to assess the current national prevalence, so as to design programmes that can achieve further reduction in the proportion of children affected.
  6,019 576 4
Barriers to acceptance of post-partum family planning among women in Montserrado County, Liberia
Virginia K Kaydor, Ikeola A Adeoye, Tubosun A Olowolafe, Adeyemi O Adekunle
July-September 2018, 25(3):143-148
DOI:10.4103/npmj.npmj_96_18  PMID:30264764
Background: Maternal mortality in Liberia is one of the highest in Sub-Saharan Africa. Post-partum family planning (PPFP) can reduce the risk of maternal mortality by preventing unwanted and closely spaced pregnancies. Yet, the uptake of PPFP is low in Liberia. Objective: We investigated the barriers to acceptance of PPFP use among women in Montserrado County, Liberia. Materials and Methods: A cross-sectional facility-based survey was conducted using a multistage sampling technique to select 378 women within 12 months' post-partum period. Results: About half of our respondents were <25 years (52.9%), 24.1% were married, 66.4% had at least secondary education and 92.1% were Christians. The most commonly reported barriers were the fear of side effects (22.0%) and the post-partum abstinence (22.2%). Binary logistic regression analysis showed that being within the early post-partum period, i.e., within the first 6 months (adjusted odds ratio [AOR] = 0.23, 95% confidence interval [CI] [0.09–0.60] and lack of access to PPFP [AOR = 0.22, 95% CI [0.09–0.52]). Importantly, women who were married [AOR = 1.686, 95% CI (0.65, 4.36)] and those who were aware of PPFP [AOR 3.69, 95% CI (1.224, 11.096)] increased the likelihood of using PPFP. Conclusion: Important barriers to the utilisation of PPFP in Liberia were being within early post-partum period, lack of access and awareness of PPFP including myths and misconception. Therefore, health communication targeting mothers for PPFP at every contact with maternal and childcare services should be encouraged.
  5,767 582 -
Factors associated with antenatal care services utilisation patterns amongst reproductive age women in Benin Republic: An analysis of 2011/2012 benin republic's demographic and health survey data
Justin Dansou, Adeyemi O Adekunle, Ayodele O Arowojolu
April-June 2017, 24(2):67-74
DOI:10.4103/npmj.npmj_16_17  PMID:28762359
Background: High maternal and neonatal mortality persist in Benin Republic despite recent improvements. Numerous women and newborns continue to suffer preventable deaths. Although factors associated with the attendance of at least one antenatal care (ANC) visit are well documented, there is little evidence on factors related to compliance with World Health Organization (WHO) recommended four ANC visits. The present study determined the extent to which reproductive age mothers received the ANC check-ups at a health facility focussing on the WHO-recommended regimen. Methods: We examined factors related to ANC services utilisation patterns amongst 8701 women recruited in the 2011/2012 Benin Demographic and Health Survey data using multinomial logistic regression. Results: The percentage of mothers with full ANC attendance was 59.56%, 27.61% received less than 4 visits and 12.84% had never attended ANC services. Results showed that out of 13 variables assessed, only the place of residence was not associated with ANC seeking. Amongst significant variables, household wealth index, female education and desire for pregnancy were the most important factors related to ANC services seeking, especially for the achievement of WHO recommended four ANC visits. The relative risk ratio of ANC attendance, for the achievement of WHO recommended four ANC regimens was high amongst mothers from economically well-off households (adjusted relative risk ratio [aRRR] for richest women = 10.6, 95% confidence interval [CI]: 6.16–18.33), educated women (aRRR for primary level = 4.34, 95% CI: 3.00–6.27) and those with desired pregnancies (aRRR = 3.4, 95% CI: 2.58–4.48). Conclusion: To achieve WHO-recommended minimum four ANC visits in Benin Republic, our findings suggest the need to financially support the most economically disadvantaged pregnant women and their families during pregnancy, advocate for reducing unmet needs for family planning, strengthen girls' education, especially by maintaining them in school till completion of at least the secondary school.
  5,400 717 7
The prevalence and risk factors for Trichomonas vaginalis infection amongst human immunodeficiency virus-infected pregnant women attending the antenatal clinics of a university teaching hospital in Lagos, South-Western, Nigeria
Olaolopin Ijasan, Kehinde Sharafadeen Okunade, Ayodeji Ayotunde Oluwole
January-March 2018, 25(1):21-26
DOI:10.4103/npmj.npmj_7_18  PMID:29676341
Background: Trichomonas vaginalis infection is the most prevalent non-viral sexually transmitted infection worldwide. Interactions between this infection and human immunodeficiency virus (HIV) may cause adverse pregnancy outcomes such as preterm labour, premature rupture of membranes, chorioamnionitis, low birth weight and post-abortal sepsis. Aims: This study was aimed to determine the prevalence and risk factors of T. vaginalis infection amongst HIV-positive pregnant women attending antenatal care at the Lagos University Teaching Hospital (LUTH), Lagos, Nigeria. Subjects and Methods: This was an analytical cross-sectional study in which 320 eligible participants which included 160 HIV-positive (case group) and 160 HIV-negative (control group) pregnant women were recruited at the antenatal clinic of LUTH. A structured pro forma was used to collect data from consenting participants after which high vaginal swabs were collected, processed and examined for T. vaginalis. The association between categorical variables was tested using the Chi-square test and Fisher's exact test where applicable. All significances were reported at P < 0.05. Results: The prevalence of T. vaginalis infection amongst HIV-positive and HIV-negative pregnant women were 10% and 8.1%, respectively (P = 0.559). Significant risk factors for T. vaginalis infection in the HIV-positive pregnant women were early coitarche (P < 0.005) and multiple lifetime sexual partners (P = 0.021). There was no relationship between the T. vaginalis infection and the immunological markers of HIV infection. Conclusions: While this study does not provide grounds for universal screening of pregnant women for T. vaginalis infection as a tool of reducing HIV acquisition, especially in pregnancy, campaign to create better sexual health awareness should be commenced as a way to contributing to the reduction in T. vaginalis infection during pregnancy and perinatal transmission of HIV.
  5,651 451 1
Oral health knowledge, awareness and associated practices of pre-school children's mothers in Greater Noida, India
Priyanka Sehrawat, KK Shivlingesh, Bhuvandeep Gupta, Richa Anand, Abhinav Sharma, Monica Chaudhry
July-September 2016, 23(3):152-157
DOI:10.4103/1117-1936.190344  PMID:27623728
Aim: To assess the oral health knowledge, awareness and associated exercised practices of pre-school children's mothers in Greater Noida, India. Subjects and Methods: The sampling frame for this study was chosen via convenient sampling. It comprised 598 mothers of children aged between 2 and 5 years, attending the paediatrics division of a government and four private hospitals in Greater Noida. A pre-tested questionnaire was distributed to the participants which comprised questions on the participant's sociodemographic characteristics and 23 statements regarding their knowledge, attitude and practices towards their child's oral health. Data were analysed using SPSS 21.0. P < 0.05 was considered statistically significant. Results: The study showed that merely 24.9% of the participating mothers had good knowledge and 29.1% and 12.5% exhibited poor attitude and practices, respectively, towards their child's oral health. Knowledge about the role of fluorides, causes and prevention of dental caries, gum disease, malocclusion, appropriate timing of commencing of toothbrushing and importance of frequent dental visit was found to be inadequate among the participants. The knowledge varied significantly with respect to age (P = 0.04), education (P = 0.00) and working status (P = 0.006) of the mothers. Conclusion: The study participants exhibited poor knowledge and attitude towards their child's oral heath which was leading to the adoption of poor oral health practices by these mothers. Thus, to improve the oral health of children, appropriate practices and measures should be promoted among their parents/guardians.
  5,222 810 4
Prevalence of chronic kidney disease and its risk factors among adults in a semi-urban community of South-East Nigeria
Chimezie Godswill Okwuonu, Innocent Ijezie Chukwuonye, Oluseyi Ademola Adejumo, Emmanuel Idoko Agaba, Louis Ikechukwu Ojogwu
April-June 2017, 24(2):81-87
DOI:10.4103/npmj.npmj_34_17  PMID:28762361
Background: Chronic kidney disease (CKD) is an increasingly prevalent problem worldwide. Treatment of end-stage kidney disease is beyond the reach of an average Nigerian. The prevention and early detection are imperative to reducing its burden. Aim: The aim of this study was to determine the prevalence of CKD and some of its risk factors among adults in a representative semi-urban Nigerian population. Subjects and Methods: A cross-sectional study involving 400 randomly selected adults. Participants were assessed using the WHO stepwise approach. Urinary protein-creatinine ratio (PCR) and estimated glomerular filtration rate (GFR) from serum creatinine, among other parameters, were analysed. A PCR ≥200 mg/g was regarded as significant proteinuria while GFR <60 ml/min/1.73 m2 was regarded as reduced GFR. Participants with abnormal PCR and/or reduced GFR were re-evaluated after 3 months to document persistence of these abnormalities. CKD was defined as persistent significant proteinuria and/or reduced GFR for more than 3 months. Results: Data were complete for 328 participants. Persistent significant proteinuria was found in 5.8% while persistently reduced GFR was obtained in 4.6% of participants. Overall, the prevalence of CKD was 7.8%. The prevalence of some established CKD risk factors was old age, 36.3%; hypertension, 36.9%; diabetes mellitus, 7.9%; and family history of kidney disease, 6.4%. The predictors of CKD included old age (adjusted odds ratio = 3.2; confidence interval: 1.10–8.92; P= 0.02), hypertension: 3.5 (1.93–11.90; P= 0.001), family history of kidney disease; 4.5 (3.91–10.23; P= 0.01), generalised obesity 1.3 (1.20–6.21; P= 0.001) and central obesity 3.8 (1.13–12.68; P= 0.003). Conclusion: The prevalence of CKD and some of its risk factors were high. Effective control of the modifiable risk factors identified will assist in reducing the burden of CKD.
  5,260 621 5
Bilateral subcapsular orchiectomy versus bilateral total orchiectomy: Comparison of the quality of life post-orchiectomy
Dubem Ejikeme Orakwe, Kehinde Habeeb Tijani, Emmauel Ajibola Jeje, Moses Adebisi Ogunjimi, Wale Ojewola Rufus, Taiwo Opeyemi Alabi
January-March 2018, 25(1):43-47
DOI:10.4103/npmj.npmj_169_17  PMID:29676345
Objective: Bilateral subcapsular orchiectomy (BSO) is said to be more aesthetic and psychologically satisfying when compared to bilateral total orchiectomy (BTO). This study compared the quality of life (QoL) of men with advanced prostate cancer who had BTO to those who had BSO, with an emphasis on their perception of self or identity as a man. Subjects and Methods: Sixty-one patients with advanced prostate cancer opting for bilateral orchiectomy were recruited. Pre-orchiectomy and at 1 month and 3 months post-orchiectomy, the Functional Assessment of Cancer Therapy for Prostate cancer (FACT-P) questionnaires were administered and scored. Results: Thirty (49.18%) patients had BTO (BTO group), while 31 (50.82%) patients had BSO (BSO group) for advanced prostate cancer. On comparison of the two groups, there were no statistically significant differences in FACT-P scores at 1 month and 3 months. The subscale scores also showed no significant statistical difference except for the physical well-being score at 3 months post-orchiectomy, which was lower in the BSO group (P = 0.041). The average scores of Item P5 (I am able to feel like a man) which were used to assess the sex-role identity declined on an average over 3 months with no statistically significant difference on comparison of the two groups. Conclusion: The QoL scores (FACT-P and FACT-G) assessed over 3 months post-orchiectomy did not differ on comparison of the BTO group and the BSO group. Performing a BSO in our region did not result in any psychological benefit when compared to performing a BTO.
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Socioeconomic status of parents and the occurrence of pelvic inflammatory disease among undergraduates attending Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria
Tijani Idris Ahmad Oseni, Michael Adeoye Odewale
April-June 2017, 24(2):114-120
DOI:10.4103/npmj.npmj_28_17  PMID:28762367
Background: Pelvic inflammatory disease (PID) is a major cause of gynaecological morbidity globally. Complications from PID include infertility, ectopic pregnancy and chronic pelvic pain. Low socioeconomic status (SES) is a risk factor for the occurrence of PID. Objective: The aim of this study was to determine the association between SES of parents and the occurrence of PID among undergraduates attending Irrua Specialist Teaching Hospital, Irrua. Methodology: The study was a hospital-based, descriptive cross-sectional study. Three hundred and sixty female undergraduates attending the hospital were consecutively recruited and clinically assessed for the presence of PID using the WHO and CDC MMWR 2010 criteria for the clinical assessment of PID. Their SES was determined by Oyedeji social class categorisation. Data were analysed using Epi Info 3.5.4. Descriptive statistics were used to summarise the data, and Chi-square was used to test for association. Results: There was a significant association between SES of parents and multiple sex partners (P < 0.02), previous sexually transmitted infection (STI) (P = 0.05), unprotected sex (P < 0.001), history of induced abortion (P < 0.001) and surgical termination of pregnancy (P < 0.01). There was also association between occurrence of PID among respondents and multiple sexual partners (P < 0.001), previous history of STI (P = 0.02), non-persistent use of condom (P < 0.001), history of induced abortion (P < 0.01) and surgical termination of pregnancy (P < 0.01). There was however no significant association between SES of parents and occurrence of PID (P = 0.14) though PID was highest among respondents from low SES. Conclusion: Occurrence of PID among undergraduates was not associated with their SES. However, identified risk factors for PID among study population such as multiple sex partners, previous STI, unprotected sex and history of induced abortion were associated with the SES.
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Comparison of visual estimation of intra-operative blood loss with haemoglobin estimation in patients undergoing caesarean section
Sampson Uzo Anya, Fidelis Anayo Onyekwulu, Elias Chukwujioke Onuora
January-March 2019, 26(1):25-30
DOI:10.4103/npmj.npmj_164_18  PMID:30860196
Background: Obstetrical haemorrhage is a potentially preventable cause of maternal morbidity and mortality; and measurements of surgical blood loss (BL) are often inaccurate. Accurate BL estimation is paramount as it may substantially alter the timing of interventions to control haemorrhage. The study compares the assessment of intra-operative BL by visual estimation with BL calculated from haemoglobin estimation using the HemoCue®201+. Materials and Methods: A total of 60 pregnant patients at term undergoing elective caesarean section under spinal anaesthesia were enrolled into the study. In the theatre, the patients' haemoglobin level was determined before and after the surgery using the HemoCue®201+; and a modified Gross formula was used to calculate the BL. BL was also visually estimated and documented by counting the blood-soaked abdominal mops and gauze pieces and multiplying them by the estimated volume of blood each would hold; fixed size mops and gauzes were used. Statistical analysis was performed to compare both methods using SPSS Version 17. To compare BL assessment, Pearson's correlation and the Bland and Altman's method of assessing agreement between two methods of clinical measurement were used. Results: The mean visually estimated BL (EBL) and HemoCue calculated BL (CBL) were 470 ± 221 ml and 563 ± 204 ml, respectively (P = 0.125). The bias (mean difference between both methods) was negligible (45.25 ml), and the limit of agreement between both methods was −222.20–275.43 ml. The discrepancy between the two methods increased when BL was ≥500 ml. Conclusion: This study showed that visually EBL was closely related to HemoCue CBL when the quantity of BL was <500 ml.
  5,382 288 1
A diagnosis of an unusual lower lip swelling: Schwannoma
Sneha Upadhyay, Jyoti Bhavthankar, Mandakini Mandale, Jayanti Humbe
July-September 2017, 24(3):191-193
DOI:10.4103/npmj.npmj_121_17  PMID:29082911
Schwannoma is a benign tumour of Schwann cell origin. Although it commonly occurs in the head and neck region, its intraoral presentation is rare. Establishing a clinical diagnosis of schwannoma is often difficult due to its non-specific clinical features. Hence, histopathological telltale features of Antoni A and Antoni B areas are unexpected in most cases. Reported here is a case of intraoral schwannoma affecting a 17-year-old male who presented with a slow growing mass in the lower lip.
  5,383 246 1
Phenotypic determination of carbapenemase producing enterobacteriaceae isolates from clinical specimens at a tertiary hospital in Lagos, Nigeria
OO Oduyebo, OM Falayi, P Oshun, AO Ettu
October-December 2015, 22(4):223-227
DOI:10.4103/1117-1936.173973  PMID:26776335
Aims and Objectives: Carbapenemase production among clinical isolates of Enterobacteriaceae has been widely reported with prevalence rates ranging from between 2.8% and 53.6%. The aim of this study was to assess the prevalence of carbapenemase production among clinical isolates of Enterobacteriaceae from a Tertiary Hospital in Lagos, Nigeria, and to characterize the type of carbapenemase produced. Materials and Methods: Carbapenemase production was detected phenotypically using a commercially available combination disc test (Rosco Diagnostica carbapenemase detection Neo-Sensitab) containing inhibitors to the various carbapenemase classes. The Neo-Sensitabs were used for Enterobacteriaceae isolates that were resistant after the initial antibiotic susceptibility testing with meropenem (10 μg). Results: A total of 177 Enterobacteriaceae isolates were investigated and 27 (15.2%) were carbapenem-resistant. From the 27 carbapenem non-susceptible isolates, 22 (12.4%) were carbapenemase producers while 5 (2.8%) exhibited carbapenem resistance due to extended spectrum beta-lactamase production. Of the 22 isolates that were positive for carbapenemase production, 15 (8.5%) were metallo beta-lactamase (MBL) producers, 6 (3.4%) produced oxacillinase-48 while 1 (0.5%) produced both MBL and Klebsiella pneumoniae carbapenemase. Hence, the overall prevalence of carbapenemase-producing Enterobacteriaceae in this study was 12.4%. Conclusion: Carbapenemase-producing Enterobacteriaceae was indeed prevalent in our institution. The combination disc test was a cost effective and suitable method for the initial detection of carbapenemase-producing Enterobacteriaceae within the clinical setting especially when molecular detection methods are not available.
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Knowledge regarding Zika virus infection among dental practitioners of tricity area (Chandigarh, Panchkula and Mohali), India
Nidhi Gupta, Ravneet Kaur Randhawa, Sahil Thakar, Mohit Bansal, Preety Gupta, Vikram Arora
January-March 2016, 23(1):33-37
DOI:10.4103/1117-1936.180179  PMID:27098947
Background: Zika virus (ZIKV), a vector-borne virus affecting a large number of people, has today become a major public health concern in the developed and developing countries worldwide. Aim: The purpose of this study was to assess the knowledge of ZIKV among dental practitioners residing in Tricity area (Chandigarh, Panchkula and Mohali), India. Subjects and Methods: A total of 412 private dental practitioners were randomly sampled of whom 254 (61.6%) responded to participate in this cross-sectional survey. A self-structured, closed-ended questionnaire was administered to each participant to record demographic and professional characteristics followed by their knowledge regarding ZIKV. Statistical analysis was performed using SPSS Version 20 (IBM Corp, Armonk, NY). The results were expressed in percentages. Multivariable linear regression analysis was carried out to assess the association of participant's demographics and professional characteristics with knowledge. Results: The sample consisted of 152 (59.9%) male and 102 (40.1%) female practitioners. Majority of the practitioners belonged to the age group of 25-34 years (66.1%). High knowledge was reported by only 38.2% of the practitioners. A statistically significant difference was seen when mean knowledge scores were compared with the qualification of the participants (P = 0.04), with postgraduates having more knowledge than graduates regarding ZIKV. Most of the knowledge of the practitioners came from television (37.8%) while journals only represented 4.7% of the total information gained. Conclusion : ZIKV infection, a new public health emergency, needs to be addressed urgently. All health care professionals should have adequate knowledge of the virus and be conversant with necessary precautionary measures to be taken making it imperative that dental practitioners strive to continually update their knowledge from time to time.
  4,545 780 12
Management of maxillofacial injuries in humans due to animal bites and mauling: A report of three cases
Pulkit Khandelwal, Neha Hajira, Shirish Dubey
October-December 2015, 22(4):241-244
DOI:10.4103/1117-1936.173981  PMID:26776339
Animal attacks and bite injuries are common occurrences as the natural habitat of animals is diminishing due to human encroachment. Individuals injured in animal attacks present with different types of injuries. Urgent and effective management of these injuries would have a significant effect on the final outcome. Rabies is a fatal disease in humans, and, till date, only those that received vaccination before the onset of illness survived this disease. The goal of the case reports presented in the article was to document the injuries suffered in animal bite injuries and add to the literature on the management with minimal complications.
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