Risky Sexual Behaviour among Students of Tertiary Institutions in South-South, Nigeria: A Qualitative Study

Background: The prevalence and global trend of risky sexual behaviours are of concern due to its attendant health implications. Apparently, the social activities of teens and young adults predispose them to risky sexual behaviour than adults, as a result of peer pressure or influence. The prevalence and global trend of risky sexual behaviours are of concern due to its attendant health implications. The study was conducted in two tertiary institutions in Rivers State, Nigeria among sixteen (16) medical and nursing students of 100 and 200 levels within the ages of 16 and 22 years;eight (8) from each institution in September 2019. The two institutions are PAMO University of Medical Sciences and University of Port Harcourt, Rivers State, Nigeria. Aim: The study is aimed at eliciting information on awareness, knowledge, attitude and involvement in risky sexual behaviours amongst the students in tertiary institutions, South of Nigeria. Information is needed for a goal and result oriented intervention programme to curb the menace of risky sexual bebaviour. This motivated the researchers to adopt a qualitative study through which in-depth information on the matter could be harvested for an effective intervention. Materials and method: A Focus Group Discussion design was adopted for the study and consists of thirteen (13) open ended questions that guided the discussion. This was designed by the chief investigator and reviewed by experts in the field for the purpose of extracting relevant information from the participants. Purposeful sampling method was adopted to make sure age criteria and both sexes were equally represented. In-depth interview method was adopted to extract information from participants over two days. Information gathered was transcribed daily and summarized in themes based on objectives of the study. Result: The study revealed that the participants have good knowledge of what risky sexual behaviours mean as well as its consequences. Majority, especially the females condemned the act even though there was carefree attitude towards risky sexual behavior as deduced from the study as participants affirm that the “pleasure in sexual relationship whether risky or not overrides the consequences”. Majority of the participants affirmed to have been involved in a risky sexual behavior at one time or the other. Conclusion: Participants expressed thirst for information and remedies to reduce the incidence of risky sexual behaviours among young adults. The information gathered would guide an intervention programme to prevent and control risky sexual behavior which is considered of a public health importance.

Sexual Behaviour among Students in a Tertiary Educational Institution in Southeast Nigeria

Background: Sexual behaviour is the manner in which humans experience and express their sexuality. When it is risky, it can lead to untoward health consequences. Objective: The study was undertaking to assess the sexuality pattern of 276 students from a tertiary educational institution in Anambra state of south eastern Nigeria to determine the pattern of risk-behavior among them. Subjects/Methods: This is a cross-sectional questionnaire based study of undergraduates in a tertiary educational institution. Results: Majority of the respondents 190/276 (68.8%) are sexually active. Most of the sexually active respondents are unmarried 156 (82.1%) while only 34 (17.9%) were married. A considerable number of the respondents 34 (17.9%) had 2 to 5 sex partners in the past one year while 26 (13.7%) had at least 6 sex partners the past year also. Interestingly, 140 (73.7%) respondents were having sex for pleasure and while only 14 (7.4%) had sex for money. Conclusion: Majority of the undergraduates in this study indulge in premarital sexual intercourse and usually often with multiple partners. This constitutes high risk sexual behavior. Recommendations: Safer-sex sexuality education is recommended for students in tertiary educational institutions to minimize this ugly trend.

Prevalence and Predictors of Non-Uptake of HIV Voluntary Counseling and Testing among Undergraduates of Tertiary Institution in Abia State, Nigeria

Background: One of the key strategies in the HIV/AIDS prevention and control programs in Nigeria is Voluntary HIV counseling and testing (VCT). However, its utilization among young adults, particularly undergraduates, is very low. The aim of the present study was to determine the prevalence and predictors of non-uptake of VCT among undergraduates. Methods: A cross sectional study using quantitative methods was conducted. Using simple random sampling, three faculties were selected out of nine and 422 respondents were selected from three faculties. Interviews were conducted using pre-tested semi-structured questionnaires. Data analysis was done using statistical package for social sciences version 20. Prevalence was measured by the percentage of respondents that had never used VCT. Analytical statistics were done using chi-square test to measure strength of association between VCT uptake and knowledge and attitude of respondents. Association with P-value < 0.05 was considered significant. Logistic regression was used to identify predictors of non-uptake of VCT. The associations were presented as odds ratios (OR) and 95% confidence intervals. Results: Overall, 59.3% of respondents were knowledgeable about VCT while majority, 64.7% had negative attitude towards it. Knowledge (X2 = 9.89, P-value < 0.001) and attitude (X2 = 10.78, P-value < 0.001) showed statistically significant association with VCT uptake. The prevalence of non-uptake of VCT among the respondents was 82.7%. Ignorance, fear of positive test, stigma and discrimination were found to be strong predictors of non-uptake of VCT. OR 1.874 (1.058 - 3.289), P < 0.001;OR 2.455 (1.308 - 4.608), P < 0.000 and OR 2.318 (1.299 - 4.128), P < 0.000 respectively. Conclusions: VCT uptake among undergraduates was low and determined by VCT-related ignorance, poor attitude, fear of positive result and HIV/AIDS-related stigma/discrimination. In order to change the narrative, HIV/AIDS prevention and control programs in Nigeria should address the identified predictors of non-VCT uptake. There is a need to focus on young adults when designing, expanding and implementing VCT services in the country.

三级医疗机构医院卫生技术评估实施现况

目的分析三级医疗机构医院卫生技术(hospital-based health technology assessment,HB-HTA)评估开展现状,为完善医疗机构HB-HTA的应用提供参考和依据。方法运用便利抽样方法,对国家卫生健康委员会医疗管理服务指导中心HB-HTA工作试点医院和已开展HB-HTA的其他医院进行问卷调查和关键知情人访谈。结果共调查19家三级医疗机构,开展HB-HTA有利于促进医疗机构科学管理决策、保障医疗质量和安全、节约医院预算、提高HB-HTA认知水平。但目前HB-HTA还存在缺乏长期持续开展的激励机制、缺乏HB-HTA相关专业人才和部门、HB-HTA流程过于繁杂、卫生技术评估时效性较差、决策支持效率较低、研究结果推广率低等问题。结论建议加强政策、资金支持,注重加强医院内部卫生技术评估人才的引进和能力培训,积极鼓励和引导医院内部建立具体HB-HTA小组或者部门,探索开发HB-HTA支持决策流程的智能化工具或软件,通过多种方式促进评估成果和评估报告的传播共享,不断完善HB-HTA的开展。

Multi-Drug Resistant Acute Otitis Media amongst Children Attending Out-Patient Clinic in Chukwuemeka Odumegwu Ojukwu University Teaching Hospital, Awka, South-East Nigeria

Objective: The study assessed microbial etiology and multi-drug resistant profile of the pathogens isolated from children diagnosed of acute otitis media (AOM) at Chukwuemeka Odumegwu Ojukwu University Teaching Hospital, Awka. Method: Ear swab samples were collected aseptically from 40 children that visited the children out-patient clinic of the hospital. The samples were cultured within 20 minutes of collection and the isolates identified microbiologically. Antimicrobial susceptibility testing was done by Kirby-Bauer’s disc diffusion method. Results: A total of 2025 children visited the hospital during the study period and 40 (1.98%) had clinical diagnosis of acute otitis media. Ten (25%) of the 40 samples did not yield any microbial growth. Children aged ≤one year had the highest prevalence of AOM (55%). Staphylococcus aureus (34.9%) was the predominant bacteria isolate followed by Pseudomonas aeruginosa (30.2%) while Candida krusei (14%) was the predominant fungi isolate. All the bacterial isolates were resistant to ampicillin and coamoxiclav. Staphylococcus aureus isolates were marginally susceptible to gentamicin (60%) and sparfloxacin (73.3%). Pseudomonas aeruginosa, Escherichia coli and Staphylococcus aureus were resistant to ceftriaxone, ciprofloxacin, streptomycin, cefuroxime, erythromycin and azithromycin. Nystatin and voriconazole had comparable effect (60%) against the fungal isolates and fluconazole was ineffective. Conclusion: The incidence of multiple antibiotic resistant bacteria associated with acute otitis media in the pediatric patient was very high. Empiric treatment of the infection in the community should be discouraged. AOM preventive strategies should be targeted on the very young children to reduce the risk of recurrence.

Assessment of breast cancer immunohistochemistry and tumor characteristics in Nigeria

BACKGROUND Female breast cancer is the leading type of cancer worldwide with an incidence of approximately 2.1 million in 2018.Hormone receptor status plays a vital role in its management.AIM To determine the molecular expression pattern of biomarkers in breast cancer and their correlation with tumor variables.METHODS This prospective study was designed to analyze expression patterns of estrogen receptor(ER),progesterone receptor(PR)and human epidermal growth factor receptor(HER2/neu)in breast cancer patients.The dataset has been taken from the Department of Radiotherapy and Oncology of Usmanu Danfodiyo University Teaching Hospital Sokoto,Nigeria from 1 January 2015 to 2 December 2019.The dataset had 259 records and 7 attributes.SPSS version 23.0 for statistical analysis was used.The data analyzed demographic and other clinicopathological characteristics as categorical variables.The mean and standard deviation were determined for the quantitative variable.RESULTS A total of 259 breast cancer cases were included in the study.The mean age was 48.3±11.0,with an age range of 26-80 years and a median age of 46 years.The morphological categories were invasive ductal carcinoma 258(99.6%)and invasive lobular carcinoma 1(0.4%).ER,positivity increased in 73 patients(50%)under the age of 50 years,as well as PR positivity increased in 34 patients(23.6%)under the age of 50 years.HER/2neupositivity decreased in 8 patients(5.6%)under the age of 50 years.Hormonal receptors were statistically significant with clinicopathological characteristics(P<0.05).CONCLUSION Our study showed that ER,PR and HER2/neuexpression had a strong correlation with age,tumor grade,tumor size and lymph node status.Hence,hormone receptor assessment is highly recommended because of its significance in clinical management and prognostication.