1.  Title: Risk factors associated with low CD4+ lymphocyte count among HIV-positive pregnant women in Nigeria. Author: Abimiku A; Villalba-Diebold P; Dadik J; Okolo F; Mang E; Charurat M Source: International Journal of Gynaecology and Obstetrics. 2009 May 20; Abstract: OBJECTIVE: To determine the risk factors for CD4+ lymphocyte counts of 200 cells/mm(3) or lower in HIV-positive pregnant women in Nigeria. METHOD: A cross-sectional data analysis from a prospective cohort of 515 HIV-positive women attending a prenatal clinic. Risk of a low CD4+ count was estimated using logistic regression analysis. RESULTS: CD4+ lymphocyte counts of 200 cells/mm(3) or lower (280+/-182 cells/mm(3)) were recorded in 187 (36.3%) out of 515 HIV-positive pregnant women included in the study. Low CD4+ count was associated with older age (adjusted odds ratio [aOR] 10.71; 95% confidence interval [CI], 1.20-95.53), lack of condom use (aOR, 5.16; 95% CI, 1.12-23.8), history of genital ulcers (aOR, 1.78; 95% CI, 1.12-2.82), and history of vaginal discharge (aOR; 1.62; 1.06-2.48). CONCLUSIONS: Over 35% of the HIV-positive pregnant women had low CD4+ counts, indicating the need for treatment. The findings underscore the need to integrate prevention of mother-to-child transmission with HIV treatment and care, particularly services for sexually transmitted infections. Language: English Keywords: NIGERIA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | PERSONS LIVING WITH HIV/AIDS | PREGNANT WOMEN | HEMATOLOGICAL EFFECTS | RISK FACTORS | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | CONDOM USE | SEXUALLY TRANSMITTED DISEASES | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Research Methodology | HIV Infections | Viral Diseases | Diseases | Population Characteristics | Demographic Factors | Population | Hemic System | Physiology | Biology | Health | Disease Transmission Control | Prevention and Control | Risk Reduction Behavior | Behavior | Reproductive Tract Infections | Infections Document Number: 341452 |
| 2. Title: Building laboratory infrastructure to support scale-up of HIV/AIDS treatment, care, and prevention: in-country experience. Author: Abimiku AG Author: Institute of Human Virology, University of Maryland School of Medicine PEPFAR Source: American Journal of Clinical Pathology. 2009 Jun;131(6):875-86. Abstract: An unprecedented influx of funds and support through large programs such as the Global Fund for AIDS, Malaria and Tuberculosis and the World Health Organization's and President's Emergency Plan for AIDS Relief (PEPFAR) has made it possible for more than 1 million persons in resource-limited settings to access AIDS treatment and several million more to be in care and prevention programs. Nevertheless, there remain major challenges that prevent AIDS drugs and care from reaching many more in need, especially in rural settings. The roll-out of a high-quality treatment, care, and prevention program depends on an effective and reliable laboratory infrastructure. This article presents a strategy used by the Institute of Human Virology (IHV)-University of Maryland and its affiliate IHV-Nigeria to establish a multifaceted, integrated tier laboratory program to support a PEPFAR-funded scale-up of its AIDS Care Treatment in Nigeria program, in collaboration with the Centers for Disease Control and Prevention and the Nigerian government, as a possible model for overcoming a key challenge that faces several resource-limited countries trying to roll out and scale-up their HIV/AIDS treatment, care, and prevention program. Language: English Keywords: NIGERIA | CRITIQUE | HIV INFECTIONS | CARE AND SUPPORT | TREATMENT | HIV PREVENTION | LABORATORY | EQUIPMENT AND SUPPLIES | LABORATORY EXAMINATIONS AND DIAGNOSES | TESTING | TUBERCULOSIS | INTEGRATED PROGRAMS | TRAINING ACTIVITIES | STANDARDS | QUALITY CONTROL | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Viral Diseases | Diseases | Health Services | Delivery of Health Care | Health | Medical Procedures | Medicine | Examinations and Diagnoses | Measurement | Research Methodology | Infections | Programs | Organization and Administration | Training Programs | Education Document Number: 341766 |
| 3. Peer Reviewed Title: Sexual activity and contraceptive use among young female students of tertiary educational institutions in Ilorin, Nigeria. Author: Abiodun OM; Balogun OR Source: Contraception. 2009 Feb;79(2):146-9. Abstract: BACKGROUND: A survey was conducted to evaluate the pattern of sexual behavior and contraceptive use among female students aged 15 to 24 years attending tertiary institutions in Ilorin, Nigeria. STUDY DESIGN: A valid and reliable semistructured questionnaire was self-administered to a sampled population of 600 students aged 15 to 24 years. RESULTS: Of the 600 students, 562 (93.7%) completed the questionnaire. Most (98.6%) of the respondents were unmarried, 77.6% have had sexual intercourse, 67.8% have had an unwanted pregnancy while 63.5% have had induced abortion. All the respondents were aware of contraceptives, but only 25.4% have ever used any contraceptive method. The most common sources of information about contraception among the respondents were friends/relatives (73.7%), while the fear of side effects of modern contraceptives was the most common reason (77.5%) for nonuse. CONCLUSION: The fear of side effects is the main reason for low contraceptive prevalence among young female students of tertiary institutions in Ilorin. Reproductive health services should focus more on delivery of adequate and accurate information about contraceptives to improve use among young women. Language: English Keywords: NIGERIA | RESEARCH REPORT | QUESTIONNAIRES | ADOLESCENTS, FEMALE | YOUTH | CONTRACEPTIVE USAGE | SEXUALITY | SEX BEHAVIOR | CONTRACEPTIVE PREVALENCE | Africa, Western | Africa, Sub Saharan | Africa | Developing Countries | Adolescents | Age Factors | Population Characteristics | Demographic Factors | Population | Contraception | Family Planning | Personality | Psychological Factors | Behavior Document Number: 329609 |
| 4. Title: The economic burden of HIV and AIDS on households in Nigeria. Author: Adedigba MA; Naidoo S; Abegunde A; Olagundoye O; Adejuyigbe E; Fakande I Source: African Journal of AIDS Research. 2009 Apr;8(1):107-114. Abstract: The study estimates the economic burden of HIV and AIDS on households in a Nigerian population. The data derive from a cross-sectional survey of households affected by HIV or AIDS in Ife-Ijesa Zone, Osun State, Nigeria. The sample consisted of 117 purposively selected, consenting adult HIV patients attending a general and teaching hospital. Participants were asked to self-report monetary expenses for HIV-related care, loss of savings, and funeral costs. The data show a significantly sharp drop in the participants' household income as a result of care for HIV-related illnesses, from the time of knowing one's HIV status to the time of illness, among three occupational categories (artisans, civil servants and unemployed; p = 0.02). Mean income among those in the unemployed category fell by 84.1%, income among artisans dropped by 72.6%, and income among civil servants decreased by 44.4%. The monetary loss during the course of HIV-related illnesses was heaviest for the artisan group, followed by the unemployed and the civil servants. Those who had lost a substantial part of their savings to HIV-related care were most numerous among the unemployed, followed by artisans and civil servants. Out of 16 households, 11 (42.3%) had received support from relatives during a funeral ceremony. There was a significant association between the occupational group and working for more hours after illness ( 2 = 9.28, df = 4; p = 0.05). Nearly all orphaned children were distributed to the extended family following the AIDS death of a parent. Among all the occupational groups, borrowing from a cooperative society during the course of HIV-related sickness was the commonest form. The findings add to data showing that despite the extended family support system, adult deaths due to AIDS continue to undermine the viability of sub-Saharan African households. Language: English Keywords: NIGERIA | RESEARCH REPORT | SAMPLING STUDIES | HOUSEHOLDS | AIDS | HIV INFECTIONS | ECONOMIC FACTORS | EXPENDITURES | INCOME | POVERTY | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Studies | Research Methodology | Family and Household | Sociocultural Factors | Viral Diseases | Diseases | Financial Activities | Socioeconomic Factors Document Number: 341292 |
| 5. Peer Reviewed Title: Term extrauterine pregnancy in a Nigerian mother: a complication of uterine dehiscence. Author: Adesiyun AG; Audu AI Source: Archives of Gynecology and Obstetrics. 2009 Jan;279(1):75-7. Abstract: Abdominal pregnancy is an uncommon but life-threatening form of ectopic pregnancy. It is associated with high maternal/fetal morbidity and mortality. We present a rare case of term abdominal pregnancy resulting from anterior uterine wall dehiscence, in a 36-year-old woman with three previous caesarean sections. The diagnosis was made at laparotomy for the fourth "caesarean section". Language: English Keywords: NIGERIA | RESEARCH REPORT | CASE STUDIES | PREGNANT WOMEN | PREGNANCY, ABDOMINAL | PREGNANCY COMPLICATIONS | TREATMENT | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Pregnancy, Ectopic | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 341008 |
| 6. Title: Post-traumatic stress disorder (PTSD) after stigma related events in HIV infected individuals in Nigeria. Author: Adewuya AO; Afolabi MO; Ola BA; Ogundele OA; Ajibare AO; Oladipo BF; Fakande I Source: Social Psychiatry and Psychiatric Epidemiology. 2009 Sep;44(9):761-6. Abstract: BACKGROUND: One of the most distressing concerns of many people living with HIV in sub-Saharan Africa is the stigma. Intense stigma may be traumatic. This study aimed to investigate the probability and correlates of Posttraumatic stress disorder (PTSD) following intense stigmatizing events and situations in HIV infected individuals in Nigeria. METHODS: Adult sero-positive attendees of an HIV care centre (N = 190) completed questionnaires regarding sociodemographic and clinical details; the 12-item General Health Questionnaire (GHQ-12) and the Rosenberg's Self-Esteem Scale. The clients were then interviewed for the presence of stigma related PTSD with a modified version of the mini international neuropsychiatry interview (MINI). RESULTS: About 2/3 of the participants had experienced at least an intense HIV-related stigmatizing event or situation. The rate of HIV-stigma related PTSD was 27.4%. Independent predictors of HIV stigma-related PTSD included past history of traumatic events (Single event, OR 2.28, 95% CI 1.08-4.73; Multiple events, OR 9.47, 95% CI 2.97-32.20), low self esteem (OR 6.52, 95% CI 2.59-16.55), poor level of social support (OR 3.33, 95% CI 1.24-9.79) and presence of general psychopathology (OR 2.18, 95% CI 1.07-4.44). CONCLUSION: PTSD may not be specific to traumatic events alone. There is a possibility of PTSD after an intense stigmatizing event or situation. While the validity for the validity of HIV-stigma related PTSD warrants further investigation, stigma needs to be considered when planning rehabilitation strategies for HIV infected individuals in sub-Saharan Africa. A closer attention to self esteem, level of social support and presence of psychopathology is needed in these individuals. Language: English Keywords: AFRICA, SUB SAHARAN | NIGERIA | RESEARCH REPORT | PERSONS LIVING WITH HIV/AIDS | STRESS | STIGMA | ANXIETY DISORDERS | HIV INFECTIONS | Africa | Developing Countries | Africa, Western | Viral Diseases | Diseases | Psychological Factors | Behavior | Social Problems | Sociocultural Factors Document Number: 342917 |
| 7. Peer Reviewed Title: Household possession, use and non-use of treated or untreated mosquito nets in two ecologically diverse regions of Nigeria--Niger Delta and Sahel Savannah. Author: Afolabi BM; Sofola OT; Fatunmbi BS; Komakech W; Okoh F; Saliu O; Otsemobor P; Oresanya OB; Amajoh CN; Fasiku D; Jalingo I Source: Malaria Journal. 2009;8:30. Abstract: BACKGROUND: Current use of treated mosquito nets for the prevention of malaria falls short of what is expected in sub-Saharan Africa (SSA), though research within the continent has indicated that the use of these commodities can reduce malaria morbidity by 50% and malaria mortality by 20%. Governments in sub-Sahara Africa are investing substantially in scaling-up treated mosquito net coverage for impact. However, certain significant factors still prevent the use of the treated mosquito nets, even among those who possess them. This survey examines household ownership as well as use and non-use of treated mosquito nets in Sahel Savannah and Niger Delta regions of Nigeria. METHODOLOGY: This survey employed cross-sectional survey to collect data from households on coverage and use of mosquito nets, whether treated or not. Fever episodes in previous two weeks among children under the age of five were also recorded. The study took place in August 1 - 14 2007, just five months after the March distribution of treated mosquito nets, coinciding with the second raining period of the year and a time of high malaria transmission during the wet season. EPI INFO version 2003 was used in data analysis. RESULTS: The survey covered 439 households with 2,521 persons including 739 under-fives, 585 women in reproductive age and 78 pregnant women in Niger Delta Region and Sahel Savannah Region. Of the 439 HHs, 232 had any mosquito nets. Significantly higher proportion of households in the Niger Delta Region had any treated or untreated mosquito nets than those in the Sahel Savannah Region. In the Niger Delta Region, the proportion of under-fives that had slept under treated nets the night before the survey exceeded those that slept under treated nets in the Sahel Savannah Region. Children under the age of five years in the Niger Delta Region were four times more likely to sleep under treated nets than those in the Sahel Savannah Region. CONCLUSION: This study found that despite the fact that treated nets were distributed widely across Nigeria, the use of this commodity was still very low in the Sahel Savannah region. Future campaigns should include more purposeful social and health education on the importance and advantages of the use of treated nets to save lives in the Sahel Savannah region of Nigeria. Language: English Keywords: NIGERIA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | PREGNANT WOMEN | MALARIA PREVENTION | BED NETS | HEALTH EDUCATION | INTERVENTIONS | IMPACT | SEASONAL VARIATION | GEOGRAPHIC FACTORS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Research Methodology | Population Characteristics | Demographic Factors | Population | Malaria | Parasitic Diseases | Diseases | Parasite Control | Public Health | Health | Education | Programs | Organization and Administration | Communication | Population Dynamics Document Number: 330812 |
| 8. Peer Reviewed Title: Presentation and survival of patients with AIDS-related Kaposi's sarcoma in Jos, Nigeria. Author: Agaba PA; Sule HM; Ojoh RO; Hassan Z; Apena L; Mu'azu MA; Badung B; Agbaji OO; Idoko JA; Kanki P Source: International Journal of STD and AIDS. 2009 Jun;20(6):410-3. Abstract: AIDS-related Kaposi's sarcoma (AIDS-KS) remains a significant cause of morbidity and mortality. We describe the pattern of presentation and survival in Jos, Nigeria. We identified 48 HIV-positive patients with AIDS-KS and matched them for age and sex with an equal number of HIV-positive patients without AIDS-KS. We compared their clinical, immunological, virological characteristics and survival. They were similar in age and body mass index profile but patients with AIDS-KS had more tuberculosis co-infection (P, 0.02), lower median CD4 count (P, 0.003) and higher mortality (P, 0.002). Surprisingly, patients with AIDS-KS had lower levels of median viral load (29,347 copies/mL) compared with controls (80,533 copies/mL). We recommend specific AIDS-KS therapy in addition to highly active antiretroviral therapy in order to improve survival. Language: English Keywords: NIGERIA | RESEARCH REPORT | PERSONS LIVING WITH HIV/AIDS | AIDS | SIGNS AND SYMPTOMS | ANTIRETROVIRAL THERAPY | LIFE EXPECTANCY | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | HIV Infections | Viral Diseases | Diseases | HIV | Length of Life | Mortality | Population Dynamics | Demographic Factors | Population Document Number: 342440 |
| 9. Peer Reviewed Title: Home-based care for people living with HIV/AIDS in Plateau State, Nigeria: findings from qualitative study. Author: Agbonyitor M Source: Global Public Health. 2009;4(3):303-12. Abstract: As health-care services in Nigeria and other African countries are becoming overstrained with patients, home-based care has increasingly been touted as a possible solution. The faith-based organisation, Gospel Health and Development Services, provides a home-based care programme for people living with HIV/AIDS (PLWHA) residing in Plateau State, Nigeria. This paper assesses the challenges that PLWHA in the programme faced while maintaining their health and livelihoods. The frustrations that volunteers endured in performing their work are also described, as well as the benefits and weaknesses of the programme from the perspective of PLWHA and their volunteer caregivers. Focus groups and interviews were done with 30 PLWHA and 22 volunteers to learn about their experiences with the home-based care programme and possible areas for its improvement. From these discussions three major challenges facing PLWHA emerged: discrimination towards PLWHA; the lack of money, food, and transport to health-care centres; and the desire for closer antiretroviral drug access. Language: English Keywords: NIGERIA | RESEARCH REPORT | QUALITATIVE RESEARCH | PERSONS LIVING WITH HIV/AIDS | VOLUNTEERS AND VOLUNTARISM | FAITH-BASED ORGANIZATION | HOME CARE | PROGRAM EVALUATION | SOCIAL DISCRIMINATION | ANTIRETROVIRAL THERAPY | TRANSPORTATION | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Research Methodology | HIV Infections | Viral Diseases | Diseases | Organization and Administration | Organizations | Political Factors | Sociocultural Factors | Care and Support | Health Services | Delivery of Health Care | Health | Programs | Social Problems | HIV | Economic Factors Document Number: 341391 |
| 10. Peer Reviewed Title: Effects of school health nursing education interventions on HIV/AIDS-related attitudes of students in Akwa Ibom State, Nigeria. Author: Akpabio II; Asuzu MC; Fajemilehin BR; Ofi AB Source: Journal of Adolescent Health. 2009 Feb;44(2):118-123. Abstract: Purpose: One of the greatest challenges facing school nurses is that of identifying and using appropriate strategies to meet the health education needs of adolescents in regard to prevention of human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS). This study examined the effects of HIV/AIDS preventive health education with parental involvement on students' attitude toward HIV/AIDS prevention in Akwa Ibom State, Nigeria. Methods: The study population comprised students from three of nine secondary schools in the study area. The three schools were randomly assigned as Intervention Group 1 (IG1), involving nurses only; Intervention Group 2 (IG2), involving both nurses and parents (IG2); and a control group. A pretest/ post-test intervention design was used. A 29-item, validated questionnaire was the instrument for data collection. Sampling involved multistage and stratified random technique to select 120 subjects from each of the three selected schools, with a total of 360 subjects representing 8.3% of the study population. From this number, 339 (94.2%) provided sufficient data for analysis. Data analysis involved analysis of covariance and the Scheffé post hoc test determined at the .05 significance level. Results: Results show significant effect of intervention on students attitudes toward preventive measures (F<234.27, p .001*). The intervention that involved nurses only was found to be a more potent strategy in providing favorable attitudes toward HIV/AIDS prevention (IG1 mean, 20.59; IG2 mean, 19.20; control mean, 12.34). Attitudes were influenced by older age but not by gender. Conclusion: Health education efforts aimed at improving HIV/AIDS-related attitudes should not only focus on children but also on parents so that they in turn could assist to improve on health workers' efforts in educating the children. Language: English Keywords: NIGERIA | RESEARCH REPORT | INTERVENTIONS | STUDENTS | NURSES AND NURSING | HEALTH EDUCATION | ATTITUDES | HIV INFECTIONS | AIDS | PARENTAL INVOLVEMENT | Africa, Western | Africa, Sub Saharan | Africa | Developing Countries | Programs | Organization and Administration | Education | Health Personnel | Delivery of Health Care | Health | Psychological Factors | Behavior | Viral Diseases | Diseases | Child Rearing Document Number: 330164 |
| 11. Title: Collective violence and attitudes of women toward intimate partner violence: evidence from the Niger Delta. Author: Antai D; Antai J Source: BMC International Health and Human Rights. 2009 Jun 9;9(12):10 p. Abstract: Background: The Niger Delta region of Nigeria has been undergoing collective violence for over 25 years, which has constituted a major public health problem. The objectives of this study were to investigate the predictors of women's attitudes toward intimate partner violence in the Niger Delta in comparison to that of women in other parts of Nigeria. Methods: The 2003 Nigeria Demographic and Health Survey was used for this study. Respondents were selected using a stratified two-stage cluster sampling procedure through which 3725 women were selected and interviewed. These women contributed 6029 live born children born to the survey. Internal consistency of the measure of the women's attitudes towards intimate partner violence against a woman was assessed using Cronbach's alpha (a). Percentage distributions of the relevant characteristics of the respondents were carried out, and multivariable logistic regression analysis was used to measure the magnitude and direction of the relationship between the outcome and predictor variables were expressed as odds ratios (OR) and statistical significance was determined at the 95 percent confident interval level (CI). Results: Tolerance for intimate partner violence among the women in the Niger delta (47 percent) was higher than that of women from the rest of the country (42 percent). Rural residence, lower household wealth, lower status occupations, and media access (newspaper and radio) were associated with lower risk of justifying IPV among the women in the Niger Delta. In contrast full or partial autonomy in household decisions regarding food to be cooked, and access to television were associated with a lower risk of justifying violence. Conclusion: The increased justification of intimate partner violence among the women in the Niger Delta could be explained by a combination of factors, among which are cognitive dissonance theory (attitudes that do not fit with other opinions they hold as a means of coping with their situation), ecological theory (behaviour or attitudes being shaped by current factors in their neighbourhood, community or family), and gender-role attitudes. Further in-depth studies are required to fully understand women's attitudes toward violence in areas of conflict. Language: English Keywords: NIGERIA | RESEARCH REPORT | DEMOGRAPHIC AND HEALTH SURVEYS | SAMPLING STUDIES | WOMEN | SEXUAL PARTNERS | DOMESTIC VIOLENCE | ATTITUDES | WAR | VIOLENCE | SOCIOECONOMIC STATUS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Demographic Surveys | Population Dynamics | Demographic Factors | Population | Studies | Research Methodology | Sex Behavior | Behavior | Crime | Social Problems | Sociocultural Factors | Psychological Factors | Political Factors | Socioeconomic Factors | Economic Factors Document Number: 341880 |
| 12. Peer Reviewed Title: Faith and child survival: the role of religion in childhood immunization in Nigeria. Author: Antai D Source: Journal of Biosocial Science. 2009 Jan;41(1):57-76. Abstract: This study assessed the role of mother's religious affiliation in child immunization status of surviving children 12 months of age and older in Nigeria, using data from the 2003 Nigeria Demographic and Health Survey (NDHS). Guided by two competing hypotheses--the 'characteristics hypothesis' and the 'particularized theology hypothesis'--variations in the risks of child immunization in Nigeria were examined using logistic regression analysis. The results indicate that religion plays a role in the risk of non-immunization; religion was not associated with the risk of partial immunization; however, religion was significantly associated with the reduced risk of full immunization. Language: English Keywords: NIGERIA | RESEARCH REPORT | DEMOGRAPHIC AND HEALTH SURVEYS | MOTHERS | CHILDREN | IMMUNIZATION | RELIGION | UTILIZATION OF HEALTH CARE | BELIEFS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Demographic Surveys | Population Dynamics | Demographic Factors | Population | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Youth | Age Factors | Population Characteristics | Primary Health Care | Health Services | Delivery of Health Care | Health | Culture Document Number: 330568 |
| 13. Title: Factors predicting BCG immunization status in northern Nigeria: a behavioral-ecological perspective. Author: Babalola S; Lawan U Source: Journal of Child Health Care. 2009 Mar;13(1):46-62. Abstract: This study examines the predictors of Bacille Calmette-Guerin (BCG) immunization status among infants in northern Nigeria using a behavioral-ecological model. The findings show only 37.3 percent of the children had received BCG vaccine, and reveal that BCG immunization status in northern Nigeria is influenced by multiple layers of factors, including child's characteristics, parental or household factors, community characteristics, vaccine supply and the policy environment. At the child's level, place of birth and ownership of an immunization card are the two most significant predictors. The parental and household predictors of BCG immunization status include maternal use of antenatal care, maternal knowledge about immunization, maternal exposure to child health information, social influence and paternal approval of immunization. Both the regularity of vaccine supply to the health facility and the state of residence are associated independently with BCG immunization status. These findings stress the need for interventions at multiple levels in order to increase BCG immunization status. Language: English Keywords: NIGERIA | RESEARCH REPORT | ACTION RESEARCH | INFANT | INFANT HEALTH | IMMUNIZATION | SOCIOECONOMIC FACTORS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Child Health | Health | Primary Health Care | Health Services | Delivery of Health Care | Economic Factors Document Number: 341722 |
| 14. Peer Reviewed Title: Media saturation, communication exposure and HIV stigma in Nigeria. Author: Babalola S; Fatusi A; Anyanti J Source: Social Science and Medicine. 2009 Apr;68(8):1513-20. Abstract: HIV-related stigma constitutes an impediment to public health as it hampers HIV/AIDS control efforts in many ways. To address the complex problems of increasing HIV infection rate, widespread misinformation about the infection and the rising level of HIV-related stigma, the various tiers of government in Nigeria are working with local and international non-governmental organizations to develop and implement strategic communication programs. This paper assesses the link between these communication efforts and HIV-related stigma using data from a nationally representative household survey. The results show that accepting attitudes towards people living with HIV are more prevalent among men than among women. Exposure to HIV-related communication on the media is associated with increased knowledge about HIV, which is in turn a strong predictor of accepting attitudes. Communication exposure also has a significant and positive association with accepting attitudes towards people living with HIV. In contrast, community media saturation is not strongly linked with accepting attitudes for either sex. The findings strongly suggest that media-based HIV programs constitute an effective strategy to combat HIV/AIDS-related stigma and should therefore be intensified in Nigeria. Language: English Keywords: NIGERIA | RESEARCH REPORT | SURVEYS | HOUSEHOLDS | PERSONS LIVING WITH HIV/AIDS | HIV INFECTIONS | AIDS | STIGMA | MASS MEDIA | COMMUNICATION PROGRAMS | ATTITUDES | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Sampling Studies | Studies | Research Methodology | Family and Household | Sociocultural Factors | Viral Diseases | Diseases | Social Problems | Communication | Psychological Factors | Behavior Document Number: 341694 |
| 15. Title: Evaluation of commercial HIV test kits used in Nigeria. Author: Banwat EB; Peter JY; Egah DZ Source: Nigerian Journal of Clinical Practice. 2009 Mar;12(1):11-4. Abstract: BACKGROUND:Accurate and reliable diagnosis of HIV plays a central role in any effective HIV intervention. We decided to evaluate 4 commercial HIV test kits to determine their reliability for use in developing countries. METHODS: Serum samples obtained from clients accessing tertiary health services at the STI clinic, Jos University Teaching Hospital were used to evaluate Sdbioline, Diaspot, Determine and DIALAB Elisa kits. A Western blot was used as the reference kit. RESULTS: DETERMINE kit gave 34 positive and 58 negative reactions and the positive sera were all confirmed by Western blot while DIASPOT kit gave 27 false negative results, which was at variance with the reference kit result. Other kits were SDBIOLINE with 5 false positive and DIALAB Elisa kit, which gave one false positive, and one false negative result. CONCLUSION: We conclude that Determine, SDbioline and DIALAB Elisa kits are reliable for HIV antibody testing in Nigeria and other developing countries. Language: English Keywords: NIGERIA | EVALUATION REPORT | CLIENTS | PROSPECTIVE STUDIES | COMPARATIVE STUDIES | HIV TESTING | EQUIPMENT AND SUPPLIES | RELIABILITY | EXAMINATIONS AND DIAGNOSES | LABORATORY PROCEDURES | SCREENING | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Evaluation | Program Activities | Programs | Organization and Administration | Studies | Research Methodology | Laboratory Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Measurement Document Number: 342689 |
| 16. Title: Integrating syndromic case management of sexually transmitted diseases into primary healthcare services in Nigeria. Author: Banwat EB; Egah DZ; Peter J; Barau C; Majang Y; Mafuyai S; Imade GE; Bukbuk DN Source: Nigerian Journal of Medicine. 2009 Apr-Jun;18(2):215-8. Abstract: BACKGROUND: Sexually transmitted diseases (STDs) are a huge public health problem; both the aetiological and clinical approaches to management have limitations. WHO has therefore developed an alternative strategy--the syndromic case management approach. This paper reports a training of healthcare providers at the Primary Health Centers aimed at integrating STD care into other services in the PHCs to improve management at the community level. METHODS: Sixteen nurses, from eight PHCs were trained on this new strategy. The training included: identification of STDs, use of flow charts, patient education and counseling, clinic management issues and record keeping and reporting. RESULTS: Over a period of eight weeks post training, about 731 clients were attended to, 451 (61.7%) had signs and symptoms of various STDs (genital discharge, genital ulcer, genital warts and lower abdominal pains). They were treated using the syndromic case approach. About 18.6% (84/451) were males and 81.4% (367/451) were Females. Singles (never married) constituted 32.8% (148/451) while 28.6% were married. About 26.6% and 12.0% were divorced and separated respectively. Age group 20-35 years was at highest risk of infection CONCLUSION: Syndromic case management of STDs can be conveniently integrated into the primary health care delivery system in Nigeria. Language: English Keywords: NIGERIA | RESEARCH REPORT | CLINICAL RESEARCH | NURSES AND NURSING | SEXUALLY TRANSMITTED DISEASES | SIGNS AND SYMPTOMS | TREATMENT | PRIMARY HEALTH CARE | INTEGRATED PROGRAMS | TRAINING ACTIVITIES | EXAMINATIONS AND DIAGNOSES | COUNSELING | PRE-POST TESTS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Research Methodology | Health Personnel | Delivery of Health Care | Health | Reproductive Tract Infections | Infections | Diseases | Medical Procedures | Medicine | Health Services | Programs | Organization and Administration | Training Programs | Education | Clinic Activities | Program Activities | Program Evaluation Document Number: 342684 |
| 17. Title: Perception and practice of emergency contraception among female undergraduates of the University of Ibadan, Nigeria. Author: Bello FA; Olayemi O; Fawole AO; Ogunbode OO; Sobukunola T Source: Journal of Reproduction and Contraception. 2009 Jun;20(2):113-121. Abstract: The authors performed a cross-sectional questionnaire study with 383 female undergraduates in Nigeria in June 2006 to assess their perceptions about and proper use of emergency contraception (EC). One hundred and five (48.2%) of the students had been sexually exposed. Only 32 (30.5%) used regular contraception. Seventy-three (24.3%) female undergraduates were aware of EC. Only 29 (7.6%) had used EC before. Most would not use EC drugs in the future due to lack of awareness (64.8%), fear for future fertility, and fear that EC was injurious to health. Use of EC was associated with awareness of correct interval for use. The authors concluded that there was poor knowledge about EC and poor use. Most knowledge was acquired from peers and was inaccurate. Language: English Keywords: NIGERIA | RESEARCH REPORT | DATA ANALYSIS | YOUTH | STUDENTS | ADOLESCENTS, FEMALE | EMERGENCY CONTRACEPTION | CONTRACEPTIVE AGENTS, POSTCOITAL | KNOWLEDGE | PEER EDUCATORS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Research Methodology | Age Factors | Population Characteristics | Demographic Factors | Population | Education | Adolescents | Contraception | Family Planning | Contraceptive Agents, Female | Contraceptive Agents | Sociocultural Factors Document Number: 339903 |
| 18. Title: Timing and determinants of mother-to-child transmission of HIV in Nigeria. Author: Charurat M; Datong P; Matawal B; Ajene A; Blattner W; Abimiku A Source: International Journal of Gynaecology and Obstetrics. 2009 Apr 3; Abstract: OBJECTIVE: To characterize the timing and determinants of mother-to-child transmission (MTCT) of HIV among mothers receiving single-dose nevirapine to prevent MTCT in Nigeria. METHODS: Three hundred and seventy-one HIV-infected mothers and their infants were followed from birth, at 1 week, and at 1, 3, 6, and 12 months. Risks of in utero (IU), intrapartum (IP/EPP), and postnatal (PP) transmission were quantified using conditional Cox regressions. RESULTS: Maternal viral load was the only risk factor for IU transmission after controlling for known risk factors. Low birth weight, premature birth, mixed feeding, and maternal viral load were associated with IP/EPP transmission. Increased PP transmission was associated with low birth weight and mixed feeding. At 6 months, mixed-fed infants were more likely to acquire infection than formula-fed infants (hazard ratio=5.74; 95% CI, 1.26-26.2). CONCLUSION: Risk factors for IU transmission differed from those of IP and PP transmission. Reducing mixed feeding and low birth weight delivery among HIV-infected mothers can further decrease IP and PP transmission. Language: English Keywords: NIGERIA | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | WOMEN IN DEVELOPMENT | MOTHERS | INFANT | PERSONS LIVING WITH HIV/AIDS | HIV TRANSMISSION | TIME FACTORS | MOTHER-TO-CHILD TRANSMISSION | ANTIRETROVIRAL THERAPY | LOW BIRTH WEIGHT | RISK FACTORS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Research Methodology | Economic Development | Economic Factors | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | Population Dynamics | Transmission | Infections | HIV | Birth Weight | Body Weight | Physiology | Biology | Health Document Number: 341465 |
| 19. Peer Reviewed Title: Youth, unemployment, and male gender predict mortality in AIDS patients started on HAART in Nigeria. Author: DeSilva MB; Merry SP; Fischer PR; Rohrer JE; Isichei CO; Cha SS Source: AIDS Care. 2009 Jan;21(1):70-7. Abstract: This retrospective study identifies risk factors for mortality in a cohort of HIV-positive adult patients treated with highly active antiretroviral therapy (HAART) in Jos, Nigeria. We analyzed clinical data from a cohort of 1552 patients enrolled in a HIV/acquired immune deficiency syndrome treatment program and started on HAART between December 2004 and 30 April 2006. Death was our study endpoint. Patients were followed in the study until death, being lost to follow-up, or the end of data collection, 1 December 2006. Baseline patient characteristics were compared using Wilcoxon Rank Sum Test for continuous variables and Pearson Chi-Square test for categorical variables to determine if certain demographic factors were associated with more rapid progression to death. The Cox proportional hazard multivariate model analysis was used to find risk factors. As of 1 December 2006, a total of 104 cases progressed to death. In addition to the expected association of CD4 count less than 50 at initiation of therapy and active tuberculosis with mortality, the patient characteristics independently associated with a more rapid progression to death after initiation of HAART were male gender, age less than 30 years old, and unemployment or unknown occupation status. Future research is needed to identify the confounding variables that may be amenable to targeted interventions aimed at ameliorating these health disparities. Language: English Keywords: NIGERIA | RESEARCH REPORT | RETROSPECTIVE STUDIES | YOUTH | MEN | PERSONS LIVING WITH HIV/AIDS | UNEMPLOYMENT | AIDS | HIV INFECTIONS | ANTIRETROVIRAL THERAPY | MORTALITY | DEATH | GENDER ISSUES | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Studies | Research Methodology | Age Factors | Population Characteristics | Demographic Factors | Population | Viral Diseases | Diseases | Employment | Macroeconomic Factors | Economic Factors | HIV | Population Dynamics | Sociocultural Factors Document Number: 331211 |
| 20. Title: Is the process of diagnosing and treating incidental medical findings a barrier to contraceptive acceptance and use? Author: Ekabua JE; Ekabua KJ; Ekanem EI; Iklaki CU Source: Journal of Obstetrics and Gynaecology. 2009 Apr;29(3):237-9. Abstract: The objective of this study is to determine the impact of diagnosing and treating incidental medical disorders on contraceptive acceptance/use. The setting was the University of Calabar Teaching Hospital, a tertiary referral centre for the South-South zone of Nigeria and South-west Cameroon. Subjects were apparently healthy women seeking contraceptive counselling at the Teaching Hospital, Calabar (2001-2005). A total of 4,990 women's records were studied for the diagnosis of incidental medical findings. Two levels of missed opportunity for contraceptive uptake were identified. Incidental medical findings were seen in 26.9% of women. Contraceptive acceptance in women with incidental medical findings was 24.8%. Defaults from the screening process and treatment of incidental medical findings were significantly associated with high parity and low social status (p < 0.5). Incidental medical disorders, although uncommon in women desiring contraception were associated with low contraceptive uptake in women with high parity and low social status. Language: English Keywords: NIGERIA | CAMEROON | RESEARCH REPORT | KAP SURVEYS | CLINICAL RESEARCH | WOMEN IN DEVELOPMENT | EXAMINATIONS AND DIAGNOSES | SCREENING | PSYCHOSOCIAL FACTORS | CONTRACEPTIVE USAGE | MULTIPARITY | SOCIAL CLASS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Surveys | Sampling Studies | Studies | Research Methodology | Economic Development | Economic Factors | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Behavior | Contraception | Family Planning | Parity | Fertility Measurements | Fertility | Population Dynamics | Demographic Factors | Population | Socioeconomic Status | Socioeconomic Factors Document Number: 330945 |
| 21. Peer Reviewed Title: Mobilizing men as partners: the results of an intervention to increase dual protection among Nigerian men. Author: Exner TM; Mantell JE; Adeokun LA; Udoh IA; Ladipo OA; Delano GE; Faleye J; Akinpelu K Source: Health Education Research. 2009 Apr 9; Abstract: This quasi-experimental, proof-of-concept study evaluated the effects of an intervention designed to help Nigerian men decrease risk for HIV/sexually transmitted infections and unintended pregnancy. The intervention was delivered in groups during two 5-hour workshops, with a monthly 2-hour check-in session. A comparison condition consisted of a group-based half-day didactic workshop. Based on recruitment area, 149 men were assigned to the intervention and 132 to the comparison. Men were evaluated at baseline and 3-month post-intervention. At follow-up, men assigned to the intervention were almost four times more likely than comparison men to report condom use at last intercourse (P < 0.001) and to report fewer unprotected vaginal sex occasions, greater self-efficacy for negotiation, a more egalitarian power dynamic in their primary relationship, more positive expectations for condom use and greater intention for future consistent condom use (all P values < 0.05). Findings suggest that this intervention is both feasible and effective. Language: English Keywords: NIGERIA | RESEARCH REPORT | KAP SURVEYS | CASE CONTROL STUDIES | MEN | SEXUAL PARTNERS | MEN'S INVOLVEMENT | HIV PREVENTION | SEXUALLY TRANSMITTED DISEASE PREVENTION | CONDOM USE | CONTRACEPTIVE USAGE | WORKSHOPS | PARTNER COMMUNICATION | PROGRAM EVALUATION | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Surveys | Sampling Studies | Studies | Research Methodology | Demographic Factors | Population | Sex Behavior | Behavior | Programs | Organization and Administration | HIV Infections | Viral Diseases | Diseases | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Risk Reduction Behavior | Contraception | Family Planning | Education | Interpersonal Relations Document Number: 341487 |
| 22. Peer Reviewed Title: Anthropometric indices of infants born to HIV-1-infected mothers: a prospective cohort study in Lagos, Nigeria. Author: Ezeaka VC; Iroha EO; Akinsulie AO; Temiye EO; Adetifa IM Source: International Journal of STD and AIDS. 2009 Aug;20(8):545-8. Abstract: Numerous studies have reported that HIV-infected pregnant women are at increased risk of delivery of low birth weight (LBW) infants, of preterm deliveries and of intrauterine growth restriction. The objective of the study was to determine the effect of maternal HIV infection on the anthropometric characteristics of the babies at birth. A prospective study was carried out at the Lagos University Teaching Hospital, Nigeria. There were three times more LBW babies in the HIV-positive group than in the uninfected mothers (odds ratio = 3.47, 95% confidence interval = 1.69, 7.27; chi(2) = 12.99, P = 0.0003).The maternal weight (t = 15.85; P = 0.0001), maternal body mass index (BMI) (t = 15.07; P = 0.0003), birth weight of infants (t = 27.17; P = 0.0001) and birth length (t = 31.20; P = 0.001) were significantly less in HIV-positive mothers than in controls. In conclusion, poor maternal bodyweight and low BMI are significant contributors to LBW in HIV-infected women. Nutritional counselling, dietary intake and weight monitoring during pregnancy should be emphasized to improve pregnancy outcome in HIV-infected women. Language: English Keywords: NIGERIA | RESEARCH REPORT | PROSPECTIVE STUDIES | COHORT ANALYSIS | PERSONS LIVING WITH HIV/AIDS | MOTHERS | INFANT | INTRAUTERINE GROWTH RETARDATION | MATERNAL NUTRITION | ANTHROPOMETRY | BIRTH WEIGHT | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Studies | Research Methodology | HIV Infections | Viral Diseases | Diseases | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Congenital Abnormalities | Neonatal Diseases and Abnormalities | Nutrition | Health | Measurement | Body Weight | Physiology | Biology Document Number: 342221 |
| 23. Title: Fertility preferences, condom use, and concerns among HIV-positive women in serodiscordant relationships in the era of antiretroviral therapy. Author: Ezeanochie M; Olagbuji B; Ande A; Oboro V Source: International Journal of Gynaecology and Obstetrics. 2009 Aug 8; Abstract: OBJECTIVE: To assess preferences and concerns about infecting partner or child among HIV-positive women undergoing antiretroviral therapy and whose partners are HIV-negative. METHOD: In this cross-sectional study conducted in Nigeria, 55 HIV-positive women undergoing antiretroviral therapy and married to seronegative men answered an anonymous questionnaire regarding whether they preferred to conceive naturally or by means of an assisted reproductive technique (ART). RESULTS: Compared with older women (mean age 33.6+/-5.1years), younger women (mean age, 29.8+/-3.9years) were significantly more likely to choose natural conception than ART (P=0.02). Moreover, whereas 23 respondents (48.9%) reported consistent condom use, 11 (23.4%) reported never using condoms after initiation of antiretroviral therapy. There was a significant difference in the consistent use of condoms between those who preferred natural conception and those who preferred ART (56.8% vs 20%, P=0.049). CONCLUSION: With improving immunologic and clinical status once antiretroviral therapy is initiated, HIV-positive women wishing to become pregnant may engage in risky sexual practices. This trend needs to be addressed because of its consequences for public health. Language: English Keywords: NIGERIA | RESEARCH REPORT | PERSONS LIVING WITH HIV/AIDS | WOMEN | FERTILITY PREFERENCES | CONDOM USE | ANTIRETROVIRAL THERAPY | QUESTIONNAIRES | REPRODUCTIVE TECHNOLOGIES | AGE FACTORS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | HIV Infections | Viral Diseases | Diseases | Demographic Factors | Population | Fertility | Population Dynamics | Risk Reduction Behavior | Behavior | HIV | Reproduction | Population Characteristics Document Number: 342492 |
| 24. Peer Reviewed Title: Multiple sexual partnership mediates the association between early sexual debut and sexually transmitted infection among adolescent and young adult males in Nigeria. Author: Fatusi A; Wang W Source: European Journal of Contraception and Reproductive Health Care. 2009 Apr;14(2):134-43. Abstract: The study was cross-sectional analytical in design and involved 1,278 Nigerian males aged 15-24 years. Logistic regression was used in assessing the statistical relationship between early sexual debut (<16 years) and self-reported STIs (history of at least one of three symptoms-painful urination, genital discharge, and genital ulcer/sore within the past 12 months), with demographic factors, sexual behaviors, and psychosocial measures controlled for. The prevalence of self-reported symptoms was 4.2% for genital discharge, 4.1% for painful urination, and 2.0% for genital sore/ulcer. Overall, 6.8% had STI symptoms. At bivariate analysis, early sexual debut (p = 0.021), multiple partners (p < 0.001), concurrent partners (p = 0.002), and sex with casual/commercial partners (p = 0.013) were associated with STIs. At multivariate analysis, early sexual debut (odds ratio [OR] = 2.12, 95% confidence interval [CI] = 1.17-3.84) remained significantly associated with STIs. Multiple sexual partnership (OR = 2.00, 95% CI = 1.13-3.52) was also significantly associated with STIs and is a mediator of the association between early debut and STI. Language: English Keywords: NIGERIA | RESEARCH REPORT | HEALTH SURVEYS | STATISTICAL REGRESSION | ADOLESCENTS, MALE | YOUTH | MULTIPLE PARTNERS | FIRST INTERCOURSE | SEXUALLY TRANSMITTED DISEASES | SIGNS AND SYMPTOMS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Health | Data Analysis | Research Methodology | Adolescents | Age Factors | Population Characteristics | Demographic Factors | Population | Sexual Partners | Sex Behavior | Behavior | Reproductive Tract Infections | Infections | Diseases Document Number: 341447 |
| 25. Peer Reviewed Title: Adherence to anti retroviral therapy (ART) during Muslim Ramadan fasting. Author: Habib AG; Shepherd JC; Eng MK; Babashani M; Jumare J; Yakubu U; Gebi UI; Saad M; Ibrahim H; Blattner WA Source: AIDS and Behavior. 2009 Feb;13(1):42-45. Abstract: Annual fasting during the month of Ramadan is observed in Muslim countries, some of which have widespread HIV infection. We studied treatment adherence and customary practices among 142 fasting 'FT' and 101 nonfasting 'NFT' patients on anti-retroviral therapy (ART) in Nigeria. Adherence on ART among FT and NFT patients was similar during Ramadan, 96% and 98%, and ever since commencement of ART, 80% and 88%, respectively. FT patients altered their typical daily behaviors by advancing morning and delaying evening doses thereby prolonging dosing intervals, eating heavier meals pre-dawn and on breakfast at sunset (78%), and changing or reducing their sleeping and waking times (40%). This preliminary study suggests that adherence and drug taking frequency appear uncompromised in FT HIV infected patients on ARVs. Language: English Keywords: ETHIOPIA | KENYA | NIGERIA | SOMALIA | SOUTH AFRICA | TANZANIA | UGANDA | RESEARCH REPORT | PERSONS LIVING WITH HIV/AIDS | ISLAM | HIV | ANTIRETROVIRAL THERAPY | USER COMPLIANCE | RELIGION | CULTURE | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Africa, Western | Africa, Southern | HIV Infections | Viral Diseases | Diseases | Sociocultural Factors | Behavior Document Number: 330156 |
| 26. Title: Interim data monitoring to enroll higher-risk participants in HIV prevention trials. Author: Halpern V; Obunge O; Ogunsola F; Otusanya S; Umo-Otong J; Wang CH; Mehta N Source: BMC Medical Research Methodology. 2009;9:44. Abstract: BACKGROUND: Lower-than-expected incidence of HIV undermines sample size calculations and compromises the power of a HIV prevention trial. We evaluated the effectiveness of interim monitoring of HIV infection rates and on-going modification of recruitment strategies to enroll women at higher risk of HIV in the Cellulose Sulfate Phase III study in Nigeria. METHODS: We analyzed prevalence and incidence of HIV and other sexually transmitted infections, demographic and sexual behavior characteristics aggregated over the treatment groups on a quarterly basis. The site investigators were advised on their recruitment strategies based on the findings of the interim analyses. RESULTS: A total of 3619 women were screened and 1644 enrolled at the Ikeja and Apapa clinics in Lagos, and at the Central and Peripheral clinics in Port Harcourt. Twelve months after study initiation, the overall incidence of HIV was less than one-third of the pre-study assumption, with rates of HIV that varied substantially between clinics. Due to the low prevalence and incidence rates of HIV, it was decided to close the Ikeja clinic in Lagos and to find new catchment areas in Port Harcourt. This strategy was associated with an almost two-fold increase in observed HIV incidence during the second year of the study. CONCLUSION: Given the difficulties in estimating HIV incidence, a close monitoring of HIV prevalence and incidence rates during a trial is warranted. The on-going modification of recruitment strategies based on the regular analysis of HIV rates appeared to be an efficient method for targeting populations at greatest risk of HIV infection and increasing study power in the Nigeria trial. TRIAL REGISTRATION: The trial was registered with the ClinicalTrials.gov registry under #NCT00120770 http://clinicaltrials.gov/ct2/show/NCT00120770. Language: English Keywords: NIGERIA | RESEARCH REPORT | CLINICAL TRIALS | DATA ANALYSIS | WOMEN | RECRUITMENT ACTIVITIES | HIV INFECTIONS | INCIDENCE | PREVALENCE | MONITORING | SEXUALLY TRANSMITTED DISEASES | SEX BEHAVIOR | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Clinical Research | Research Methodology | Demographic Factors | Population | Program Activities | Programs | Organization and Administration | Viral Diseases | Diseases | Measurement | Evaluation | Reproductive Tract Infections | Infections | Behavior Document Number: 342632 |
| 27. Peer Reviewed Title: What is the fate of the missing intrauterine contraceptive device? Author: Ibitoye BO; Aremu AA; Onuwaje MA; Ayoola OO Source: Tropical Doctor. 2009 Oct;39(4):221-3. Abstract: An intrauterine contraceptive device (IUCD) is one of the most common forms of contraception in use worldwide today. It is associated with a myriad of problems and complications, one of which is the missing IUCD. It is a known fact that IUCDs can perforate the uterus resulting in its subsequent relocation in other organs within the pelvis and the abdomen. This study showed that more than 50% of clinically diagnosed cases of a missing IUCD are still located within the endometrial cavity. It is therefore being proposed that a clinical diagnosis of 'missing string' be made until adequate radiological investigations, such as ultrasonography, plain X-rays and computerized tomography, have been carried out. Language: English Keywords: GLOBAL | NIGERIA | RESEARCH REPORT | INCIDENCE | WOMEN | IUD | IUD COMPLICATIONS | IUD MIGRATION | EXAMINATIONS AND DIAGNOSES | ULTRASONICS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Measurement | Research Methodology | Demographic Factors | Population | Contraceptive Methods | Contraception | Family Planning | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 342764 |
| 28. Title: Prevalence and predictors of tuberculosis coinfection among HIV-seropositive patients attending the Aminu Kano Teaching Hospital, northern Nigeria. Author: Iliyasu Z; Babashani M Source: Journal of Epidemiology / Japan Epidemiological Association. 2009;19(2):81-7. Abstract: BACKGROUND: The HIV/AIDS epidemic has been accompanied by a severe epidemic of tuberculosis (TB), although the prevalence of coinfection is largely unknown, especially in developing countries, including Nigeria. The aim of this study was to determine the prevalence and predictors of TB coinfection among HIV-seropositive Nigerians. METHODS: The case files of HIV/AIDS patients attending Aminu Kano Teaching Hospital, Nigeria from January to December 2006 were reviewed. RESULTS: A total of 1320 HIV/AIDS patients had complete records and were reviewed, among which 138 (10.5%) were coinfected with TB (95% CI, 8.9% to 12.2%). Pulmonary TB was diagnosed in 103 (74.6%) patients, among whom only 18 (17.5%) were sputum-positive. Fifty (36.2%) coinfected patients had some type of extrapulmonary TB (EPTB); 15 had both pulmonary TB and EPTB. Among the 35 patients with EPTB only, 20 (57.1%) had abdominal TB, 5 (14.3%) had TB adenitis, 5 (14.3%) had spinal TB, 3 (8.6%) were being monitored for tuberculous meningitis, and 1 (2.9%) each had renal TB and tuberculous adrenalitis. The highest prevalence of TB, 13.7% (n = 28), was seen among patients aged 41-50 years. TB coinfection was significantly associated with marital status, WHO clinical stage, and CD4 count. Marital status (OR, 2.1; 95% CI, 1.28-3.59; P = 0.04), WHO clinical stage at presentation (4.81; 1.42-8.34; P = 0.001), and baseline CD4 count (2.71; 1.51-6.21; P = 0.02) remained significant predictors after adjustment for confounding. CONCLUSIONS: The moderately high prevalence of TB among HIV-seropositive patients underscores the urgent need for strategies that lead to rapid identification and treatment of coinfection with active or latent TB. Language: English Keywords: NIGERIA | RESEARCH REPORT | RETROSPECTIVE STUDIES | PERSONS LIVING WITH HIV/AIDS | CLIENTS | HIV INFECTIONS | TUBERCULOSIS | PREVALENCE | ANTIRETROVIRAL THERAPY | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Studies | Research Methodology | Viral Diseases | Diseases | Program Activities | Programs | Organization and Administration | Infections | Measurement | HIV Document Number: 341951 |
| 29. Title: Review of maternal deaths from unsafe abortion in Jos, Nigeria. Author: Kigbu JH; Daru PH; Ujah IA Source: Nigerian Journal of Medicine. 2009 Jan-Mar;18(1):103-6. Abstract: BACKGROUND: Unsafe Abortion assumes one of the lead causes of maternal deaths so long as contraceptive services remain low or unavailable and abortion laws remain restrictive. This study seeks to highlight abortion mortality, the practice of contraception amongst these women and complications arising from unsafe abortion. METHOD: This is a retrospective review of abortion related deaths in Jos University Teaching Hospital over a five year period (1st December 1989 to 30th November 2004). Patients files were retrieved from the hospital records and were reviewed in relation to socio demographic profile, clinical features and cause of death. RESULTS: Fourteen cases of abortion related deaths out of a total number of 188 induced abortion cases. The case fatality rate was 7.4% with abortion mortality of 74.4/100,000 deliveries. It constituted 12.8% of maternal deaths during the period. Seventy eight point six percent (78.6%) were below 24 years, while 85.7% of the patients were nulliparous. Ninety two point nine percent (92.9%) and 57.1% were single and dependent respectively. Fifty seven point one percent had never practiced contraception and 35.7% had previous pregnancy terminated. In 64.3%, the index pregnancy was terminated at 9 weeks and above because the pregnancies were unwanted in all (100%) cases. In 78.6% of cases the pregnancies were terminated by quacks. Forty two point nine percent (42.9%) presented after a week of termination. The causes of death were septicemia (71.4%), and hypovolaemic shock (28.6%). The average duration of hospital stay before demise was 5.6 days. CONCLUSION: Unsafe abortion is a public health problem in Jos and policy makers should promote contraception and review existing abortion laws. Language: English Keywords: NIGERIA | RESEARCH REPORT | RETROSPECTIVE STUDIES | MATERNAL MORTALITY | ABORTION | SAFETY | RISK FACTORS | DEATH RATE | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Studies | Research Methodology | Mortality | Population Dynamics | Demographic Factors | Population | Fertility Control, Postconception | Family Planning | Public Health | Health Document Number: 341718 Notification |
| 30. Peer Reviewed Title: Patterns of soil-transmitted helminth infection and impact of four-monthly albendazole treatments in preschool children from semi-urban communities in Nigeria: a double-blind placebo-controlled randomised trial. Author: Kirwan P; Asaolu SO; Molloy SF; Abiona TC; Jackson AL; Holland CV Source: BMC Infectious Diseases. 2009;9:20. Abstract: BACKGROUND: Children aged between one and five years are particularly vulnerable to disease caused by soil-transmitted helminths (STH). Periodic deworming has been shown to improve growth, micronutrient status (iron and vitamin A), and motor and language development in preschool children and justifies the inclusion of this age group in deworming programmes. Our objectives were to describe the prevalence and intensity of STH infection and to investigate the effectiveness of repeated four-monthly albendazole treatments on STH infection in children aged one to four years. METHODS: The study was carried out in four semi-urban villages situated near Ile-Ife, Osun State, Nigeria. The study was a double-blind placebo-controlled randomised trial. Children aged one to four years were randomly assigned to receive either albendazole or placebo every four months for 12 months with a follow-up at 14 months. RESULTS: The results presented here revealed that 50% of the preschool children in these semi-urban communities were infected by one or more helminths, the most prevalent STH being Ascaris lumbricoides (47.6%). Our study demonstrated that repeated four-monthly anthelminthic treatments with albendazole were successful in reducing prevalence and intensity of A. lumbricoides infections. At the end of the follow-up period, 12% and 43% of the children were infected with A. lumbricoides and mean epg was 117 (S.E. 50) and 1740 (S.E. 291) in the treatment and placebo groups respectively compared to 45% and 45% of the children being infected with Ascaris and mean epg being 1095 (S.E. 237) and 1126 (S.E. 182) in the treatment and placebo group respectively at baseline. CONCLUSION: Results from this study show that the moderate prevalence and low intensity of STH infection in these preschool children necessitates systematic treatment of the children in child health programmes. Language: English Keywords: NIGERIA | RESEARCH REPORT | PREVALENCE | CHILDREN | CHILD NUTRITION | GASTROINTESTINAL EFFECTS | INFECTIONS | VITAMINS AND MINERALS | DEFICIENCY DISEASES | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Measurement | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Nutrition | Health | Physiology | Biology | Diseases | Nutrition Disorders Document Number: 330549 |
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