BackgroundIn Nigeria, as in the rest of equatorial Africa, sickle cell disease (SCD) has its highest incidence and continues to cause high morbidity and early death. The condition is a major public health problem among the black race. The aim of this survey is to determine the level of knowledge about SCD and the factors associated with its prevention among local government workers in Ile-Ife.MethodThis is a cross-sectional descriptive study of the knowledge about SCD, attitude towards premarital sickle cell screening and marital decisions among local government workers in Ile-Ife, Nigeria, using a self-administered questionnaire.Results69% of study subjects had poor knowledge of SCD, while attitude towards premarital screening was favourable in 95% of the study subjects. Knowledge and attitude were significantly better among subjects with tertiary education. There was a strong positive association between attitude towards sickle cell screening and a history of undergoing screening or partner screening. Most (86.7%) of the respondents and 74.0% of their partners have had sickle cell screening. One-quarter of married and engaged respondents did not know their partner's sickle cell status. One-third to two-thirds of study subjects will continue the relationship with their partner when either or both have haemoglobinopathy.ConclusionThis study showed poor knowledge of SCD among the studied subjects. There is a need for more emphasis on health education through programmes promoting sickle cell education. In addition, the development of multifaceted patient and public health education programmes, the intensification of screening for the control of SCD by heterozygote detection, particularly during routine preplacement and premarital medical examinations, and the provision of genetic counselling to all SCD patients and carriers are vital to the identification and care of the couples at risk. These will enhance the capacity of the intending couples to make informed decisions and be aware of the consequences of such decisions. Policies are needed to ensure easily accessible community-wide sickle cell screening and premarital and genetic counselling to achieve the desired decline in new births of children with SCD.

BackgroundDiabetes mellitus is a non-communicable disease with a rising prevalence worldwide. Most of the increase in prevalence is projected to be in the developing countries. As it is recognised that the onset of the disease and its complications predate the symptoms, it is expedient that screening procedures are undertaken to diagnose the disease in the individual as early as possible to minimise the risk of complications. Diabetes mellitus is a chronic disease necessitating life-long therapy, usually with drugs. This creates a life-long financial burden on the family, especially in low socio-economic communities in West Africa, where the majority of the population still lives on less than one dollar a day. This affects the wellbeing of the entire family, hence the need for early detection, prompt and adequate management of the disease and avoidance of its complications. MethodsThe study is an incidental screening to determine the prevalence of diabetes mellitus, its risk factors and the clinical characteristics of diabetics in a Nigerian family practice population. Four hundred and twenty subjects aged 15 years or older were recruited by systematic random sampling in a family practice in South West Nigeria over a three-month period. Data collected include the subjects' socio-demographic data, family history of diabetes mellitus and hypertension, and history of tobacco and alcohol use. The subjects' weight and height were measured and their body mass index (BMI) calculated. Each subject was examined for peripheral neuropathy, lens opacity and hypertension. Fasting blood glucose was measured using a glucometer and urine was tested for albumin. Those with a fasting blood glucose of greater than 6.1 had a fasting blood glucose determination by the standard spectrophotometric method. ResultsTen (2.38%) subjects were known diabetics, while 57 (13.6%) were known hypertensives. Ten (2.38%) new diabetics were identified, and 7.5% of the females compared to 5.8% of the males were diabetic. Alcohol intake, obesity, age above 44 years and a positive parental history of diabetes were the significant risk factors (p < 0.01) for diabetes in the study. Proteinuria and peripheral neuropathy were the significant complications (p < 0.01). ConclusionsIt is concluded that diabetes is a common problem in our practice, with a prevalence of 4.76%, half of which was previously undiagnosed. Alcohol intake, obesity, positive parental history and age over 44 years were the identified risk factors. Peripheral neuropathy, proteinuria and high blood pressure were the identified complications. It is recommended that routine screening of people at high risk of diabetes mellitus in family practice be commenced. The glucometer, a relatively cheap item of equipment in the practice, is a highly useful, sensitive and specific tool for this purpose. Pract 2007;49(8):15 SA Fam

S Afr Fam Pract 2011;53(1):63-70Background: Sexually transmitted infections (STIs) are among the most common infectious diseases in the world today. There are few reliable statistics on the true prevalence of STIs in developing countries, especially in the general practice setting, hence the need to determine the prevalence in each locality. With the scourge and pandemicity of human immunodeficiency virus (HIV) and the fact that STIs are recognised as independent risk factors for its transmission, determining the risk profiles for STIs has become paramount. The aim of this study was to describe the pattern of STIs among patients attending a Nigerian general practice (GP) clinic.Methods: This was a descriptive, cross-sectional, hospital-based study. Consenting patients were recruited serially between February and April 2006 until the sample size of 415 was reached. Subjects' genital symptoms were considered according to the four common STI syndromes according to National AIDS/STD Control Programme guidelines.Results: The age range of the subjects was 15 to 95 years (mean 45.16 years, standard deviation 18.83 years, median 44 years). The median age at coitarche was 21 years while the median age at marriage was 25 years. The prevalence rates of current, past and lifetime STI were 18.8%, 22.4% and 32% respectively. Only 28 (6.8%) study subjects had laboratory evidence of STIs at the time of study. Previous sex with a commercial sex worker, previous history of STIs, premarital sex, first intercourse before or at 21 years of age and multiple sexual partners were significantly associated with STIs. Previous history of STIs was a strong predictor of current STI in this study while premarital sex and previous sex with a commercial sex worker were strong predictors of past STI. The frequency of HIV infection among subjects with STIs was more than double that of the control and a co-infection rate of 17.9% was found.Conclusions: The findings of this study indicate a high prevalence of STIs in the study community in association with prevailing high sexual risk behaviours, hence the need for reliable control programmes targeting the latter.Peer reviewed.

The outcome of a young person's future is affected by the support received from the family. Support that is received is related to the quality of family functioning of the young person. Family-oriented interview assesses the family of a patient who presents for consultation, through the patient. It diagnoses relationship issues in a family and helps in solving them. It may be best suited for the young-person encounter in a clinic as it ensures privacy, an important requirement for young-person care. The study objective was to assess the perceived family function of young persons and the perceived effect on this of family-oriented interview. The study had a quasi-experimental, pre-and post-test design, and the setting was in the family medicine clinic. Family-oriented interview was conducted for 221 young persons after an initial family function assessment. They were each followed up for 12 weeks and family function was reassessed. Perceived family function was significantly associated with very close relationships with the family members, especially fathers and mothers. Family-oriented interview may have significantly improved perceived family function in the study. Family-oriented interview of young persons presenting for medical care is recommended.

Objective We determined the malaria prevalence and ascertained the degree of agreement among rapid diagnostic tests (RDTs), urine malaria tests, and microscopy in malaria diagnosis of adults in Nigeria. Methods This was a cross-sectional study among 384 consenting patients recruited at a tertiary health facility in southwestern Nigeria. We used standardized interviewer-administered questionnaires to collect patients’ sociodemographic information. Venous blood samples were collected and processed for malaria parasite detection using microscopy, RDTs, and urine malaria tests. The degree of agreement was determined using Cohen’s kappa statistic. Results The malaria prevalence was 58.3% (95% confidence interval [CI]: 53.0–63.1), 20.6% (95% CI: 16.6–25.0), and 54.2% (95% CI: 49.0–59.2) for microscopy, RDTs, and urine malaria test, respectively. The percent agreement between microscopy and RDTs was 50.8%; the expected agreement was 45.1% and Cohen’s kappa was 0.104. The percent agreement between microscopy and urine malaria tests was 52.1%; the expected agreement was 50.7% and Cohen’s kappa was 0.03. Conclusion The malaria prevalence was dependent on the method of diagnosis. This study revealed that RDTs are a promising diagnostic tool for malaria in resource-limited settings. However, urine malaria test kits require further improvement in sensitivity prior to field use in malaria-endemic settings.

No abstract

Background Antenatal care (ANC) is a recognized factor for favorable pregnancy outcomes. Despite the benefits associated with early initiation of antenatal care, late booking still predominates in sub-Saharan Africa including Nigeria. Objective This study aimed to assess the factors, including family dynamics, associated with the booking gestational age among women attending ANC clinics in a Local Government Area of Osun State, Nigeria. Methods A descriptive cross-sectional study was conducted among 255 pregnant women attending ANC at the Primary Health Centres in Osun State, who were selected by stratified random sampling technique. Data were obtained with aid of a semi-structured questionnaire and subjected to descriptive and inferential analyses. Results The mean age of respondents was 27.3 ± 5.1 years. Their mean booking gestational age was 23.0 ± 6.6 weeks, while the majority (85.3%) booked late for ANC. Most (122, 54.2%) of the respondents booked in the second trimester. The opinion of the husband influenced most women (54.2%) in the decision regarding the time of ANC booking. There was no association between the booking gestational age and each of respondents’ age, education, parity, perceived family support, level of family functioning, and other sociodemographic characteristics. The booking GA was however significantly related to the previous booking GA at the last pregnancy ( p = .004). Conclusion Late initiation of antenatal care was high among pregnant women attending PHCs in the study area and it was not associated with measures of family dynamics. The predominant influence of husbands’ opinion on time of booking suggests the need for strategic outreach to males through relevant reproductive health educational campaigns.

The outcome of a young person’s future is affected by the support received from the family. Support that is received is related to the quality of family functioning of the young person. Family-oriented interview assesses the family of a patient who presents for consultation, through the patient. It diagnoses relationship issues in a family and helps in solving them. It may be best suited for the young-person encounter in a clinic as it ensures privacy, an important requirement for young-person care. The study objective was to assess the perceived family function of young persons and the perceived effect on this of family-oriented interview. The study had a quasi-experimental, pre- and post-test design, and the setting was in the family medicine clinic. Family-oriented interview was conducted for 221 young persons after an initial family function assessment. They were each followed up for 12 weeks and family function was reassessed. Perceived family function was significantly associated with very close relationships with the family members, especially fathers and mothers. Family-oriented interview may have significantly improved perceived family function in the study. Family-oriented interview of young persons presenting for medical care is recommended.