Institutions In Southwestern Nigeria Research Articles

Prevalence of Infertility and Acceptability of Assisted Reproductive Technology among Women Attending Gynecology Clinics in Tertiary Institutions in Southwestern Nigeria

This study is aimed to assess the level of awareness and perceptions of Assisted Reproductive Technology among women attending fertility clinics in Osun State South West Nigeria. A total of 257 women attending gynecology clinics in Osun State teaching hospitals (LAUTECH and OAU Teaching Hospitals) were recruited through systematic sampling technique, using a pre-tested, semi-structured, interviewer administered questionnaire. Only 46% of the respondents were aware of ART. About 73.5% of those that were aware would opt for it. Thirty five point six percent of those who rejected IVF claimed that the cost was high, 31.1% of them believed that only God gives babies while 18.9% of was the opinion that the procedure may fail. 25.6% believed ART babies are artificial babies. Only 24.3% knew where the services were offered while 16.5% were only aware of the cost. 192(76.8%) has a positive attitude to ART. Duration of infertility, being married and high educational status were the predictors of being aware of ART, giving support for ART and opting for ART as a solution to the problem of infertility. There was a low awareness about ART and educational status influenced level of awareness. There is need to put in more efforts in spreading the knowledge of in-vitro fertilization in developing countries like Nigeria. Efforts should be made to make the procedure more affordable and accessible.

The effects of management use of motivation on workers' job commitment: an empirical investigation of tertiary institutions in South-western Nigeria

This paper examines the perceived effects of management use of motivation on workers’ job commitment in tertiary institutions in South-western Nigeria. The empirical study was conducted via the administration of 2,680 questionnaires on teaching and non-teaching staff of selected institutions. Using the framework from Aborisade and Obioha (2009) and Khong (2005), factors manifesting employee’s job commitment were regressed on the key factors manifesting successful motivation. The dataset from the sample underwent series of statistical analysis (validity and reliability analysis, factor analysis-exploratory and confirmatory- and hypothesis testing). This study confirmed that motivation had a significant association on workers’ job commitment. The empirical analysis conducted on the data revealed that workers of the institutions were not well motivated. The motivation schemes designed for the workers were not adequate and able to meet up with the level of expectation of the employees. The findings could be used by Nigerian universities to compose strategies to optimise their management of workers job commitment and motivational/reward policies. Policy implications were highlighted at the end of this report.

Seroprevalence of Hepatitis B Surface Antigen and Antibody among Pregnant Women Attending a Tertiary Health Institution in Southwestern Nigeria

Seroprevalence of Hepatitis B Surface Antigen and Antibody among Pregnant Women Attending a Tertiary Health Institution in Southwestern Nigeria

A comparison of orally administered misoprostol and membrane sweeping for labour induction in uncomplicated, singleton post-term pregnancies

Objectives. This study assessed the efficacy of the two outpatient processes of single-dose 50 μg oral misoprostol (OM) and membrane sweeping (MS) on the outcome of labour induction and the possibility of reducing the need for hospital admission for cervical ripening/labour induction in uncomplicated post-term singleton pregnancies at a tertiary health institution in south-western Nigeria. Methods. A total of 100 patients were equally randomised into the two groups between April 2007 and March 2010. Primary outcome measures were delivery within 48 hours after the start of induction and route of delivery. Secondary outcome measures were time interval from induction to onset of labour (latency period), time interval from start of induction to delivery (duration of labour), need for oxytocin augmentation, labour complications, Apgar scores at 1 and 5 minutes, and need for neonatal intensive care unit (NICU) admission. Results. Both groups were similar at the baseline with regard to age, parity and days beyond 40 weeks’ gestation. There was a significantly shorter induction to onset of labour (latency) interval in the OM group, with a mean of 17.0 hours compared with 31.9 hours in the MS group (p=0.005), with 82.0% of the patients in the OM group in spontaneous labour within the latency period of 18 hours as opposed to 32.6% of the MS group (p<0.005). Forty-two patients in the OM group and 40 in the MS group had a vaginal delivery (84.0% v. 87.0%, p=0.361), with 12 and 20 patients in the OM and MS groups, respectively, requiring oxytocin augmentation (p=0.023). The duration of labour was significantly shorter in the OM group, in which 78.6% of those who had a vaginal delivery achieved it within 9 hours, compared with 57.5% in the MS group (p=0.036). Overall, neonatal outcomes and need for NICU admission were similar and comparable in the two groups. On a preference scale, 43% of the women in the MS group felt positive about the intervention, compared with 92% of the women in the OM group. Conclusion. The study demonstrated a shorter latency period, less need for oxytocin augmentation and shorter duration of labour in patients who received OM. The two induction agents were similar with regard to neonatal outcomes and need for NICU admission. Both showed good safety profiles for outpatient care, although further assessment of the safety profile with larger studies will be needed. More patients felt positive about the intervention in the OM group than in the MS group. S Afr J OG 2013;19(1):4-7. DOI:10.7196/SAJOG.584

Caesarean section at a tertiary institution in Southwestern Nigeria—A 6-year audit

Introduction: Caesarean section is one of the commonest surgical procedures worldwide. Its upward trend and associated morbidity/mortality especially in low-resource setting makes regular appraisal of the practice necessary. Methodology: A retrospective study. Labour ward logbook and case records were looked into, and all information extracted. Results: Caesarean section rate was 35.5%, with an upward trend. Perinatal death was still high. Main indication was previous caesarean section followed by obstructed labour while major maternal morbidity was wound sepsis. Identifiable factors to perinatal death were multiparity, emergency caesarean section and women that were referred to our health facility. Conclusion: Risk appraisal and all efforts must be geared towards reducing caesarean section rate especially in our environment where subsequent deliveries might not be attended to by skilled health personnel.

Awareness and knowledge of glaucoma among workers in a nigerian tertiary health care institution

Purpose:The aim of this study reports the level of awareness and knowledge of glaucoma among selected health care personnel at a health institution in southwestern Nigeria.Materials and Methods:Health personnel at the Federal Medical Centre, Owo, Nigeria, a tertiary health care institution were stratified into a clinical and an administrative directorate. One-hundred twenty participants were selected from each directorate by a random sampling technique. A structured questionnaire was used to collect sociodemographic data and data on the level of knowledge and awareness of glaucoma. Statistical analyses included the independent t-test and Pearson's chi-square test for categorical variables. Statistical significance was indicated by P < 0.05.Results:From the target population of 240 participants, 216 (98 males; 118 females) completed the questionnaire. The mean age of the participants was 35.07 ± 07 years. A total of 148 (68.6%) participants had heard of glaucoma comprising all participants from the clinical directorate and 28 participants from the administrative directorate. There was no statistically significant difference between the clinical and administrative directorates about the knowledge of the aspect of vision that is first affected by glaucoma, the painless nature of glaucoma among most Africans and the irreversible nature of glaucoma-related blindness (P > 0.05, all comparisons).Conclusion:There is the need to update the knowledge base of these workers if they are to be useful in propagating information of the irreversible blindness that could arise from delay in glaucoma diagnosis and treatment.

An audit of Ear, Nose and Throat diseases in a tertiary health institution in South-western Nigeria

IntroductionThis study is aimed at determining the pattern of ear, nose and throat diseases and their relationship with socio-demographic factors with auditing intent in a tertiary hospital in South-western Nigeria.MethodsMedical records of patients managed at the Department of Otorhinolaryngology, University College Hospital, Ibadan, Nigeria from 2006 to 2010 were reviewed for all essential clinical data.ResultsThere were 2641 (52.8%) males and 2360 (47.2%) females. Two thousand and fifty (41%) patients had age ≤15years old. Sixty three percent of the patients were Christians, 37% were Muslims and less than 1% had other religions. There were more patients in lower occupational classes than those in the upper classes. The average number of patients with ear, nose and throat diseases managed per month was eighty three. Patients with ear diseases were 3136 (62.7%), the nose diseases were 1153 (23.0%), the throat diseases were 479 (9.6%) and head/neck diseases were 233 (4.7%).ConclusionThis study showed that otitis media, obstructive adenoid, foreign bodies in the ear and throat infections were the common ear, nose, throat disorders seen in patients aged ≤15years whereas, hearing loss, rhinosinusitis and tumors were the common disorders of ear, nose and throat seen in patients aged 16 years and above. Although these disorders are not yet considered to be of public health importance, they contribute significantly to the existing burden of health problems in our environment. Therefore, there is a need for improved public awareness on ear, nose and throat diseases.

Breaking bad news in clinical setting - health professionals′ experience and perceived competence in southwestern Nigeria: A cross sectional study

Communication skills are vital in clinical settings because the manner in which bad news is delivered could be a huge determinant of responses to such news; as well as compliance with beneficial treatment option. Information on training, institutional guidelines and protocols for breaking bad news (BBN) is scarce in Nigeria. We assessed the training, experience and perceived competence of BBN among medical personnel in southwestern Nigeria. The study was a cross-sectional descriptive study conducted out among doctors and nurses in two healthcare institutions in southwestern Nigeria using an anonymous questionnaire (adapted from the survey by Horwitz et al.), which focused on the respondents training, awareness of protocols in BBN; and perceived competence (using a Five-Point Likert Scale) in five clinical scenarios. We equally asked the respondents about an instance of BBN they have recently witnessed. A total of 113 of 130 selected (response rate 86.9%) respondents were studied. Eight (7.1%) of the respondents knew of the guidelines on BBN in the hospital in which they work. Twenty-three (20.3%) respondents claimed knowledge of a protocol. The median perceived competence rating was 4 out of 5 in all the clinical scenarios. Twenty-five (22.1%) respondents have had a formal training in BBN and they generally had significant higher perceived competence rating (P = 0.003-0.021). There is poor support from fellow workers during instances of BBN. It appears that the large proportion of the respondents in this study were unconsciously incompetent in BBN in view of the low level of training and little or no knowledge of well known protocols for BBN even though self-rated competence is high. Continuous medical education in communication skills among health personnel in Nigeria is advocated.

Pattern of Tooth Extraction in Children Attending Tertiary Health Care Centers In Nigeria: A Prospective Study

To identify the causes of tooth extraction in a tertiary pediatric center in an urban centre in Nigeria. Data was collected prospectively from 400 children attending one of the four tertiary dental clinics. The demographic profile, the indications for tooth extraction, and the tooth extracted were noted. Data was compared with result of study conducted 21 years back in the same center, and data from two other tertiary health centers in the region. The prevalence of tooth extraction was 58.8% in the study population. This occurred in significantly more male patients. Tooth loss was commonest amongst the 7-10 age group. Dental caries was the main cause of tooth loss for all age groups. Most patients (66.0%) lost a single tooth. The lower molars were the most frequently lost teeth (47%). Indications for tooth extraction were similar in the region. Dental caries remains the most common cause of tooth extraction. The indications for tooth extraction remain the same but the prevalence of tooth loss per cause of tooth loss had not changed over the last 21 years, and across institutions in Southwestern Nigeria.

Maternal and Fetal Outcome of Obstetric Emergencies in a Tertiary Health Institution in South-Western Nigeria

Objective. This study was carried out to determine the pattern of obstetric emergencies and its influence on maternal and perinatal outcome of obstetric emergencies at the Olabisi Onabanjo University Teaching Hospital (OOUTH), Sagamu, Nigeria. Method. A retrospective study of obstetric emergencies managed over a three-year period at Olabisi Onabanjo University Teaching Hospital (OOUTH), Sagamu, Nigeria was conducted. Results. There were 262 obstetric emergencies accounting for 18.5% of the 1420 total deliveries during the period. Unbooked patients formed the bulk of the cases (60.3%). The most common emergencies were prolonged/obstructed labour, postpartum haemorrhage, fetal distress, severe pregnancy-induced hypertension/eclampsia, and antepartum haemorrhage. Obstetric emergencies were responsible for 70.6% of the maternal mortality and 86% of the perinatal mortality within the period. Conclusion. Prevention/effective management of obstetric emergencies will help to reduce maternal and perinatal mortality in our environment. This can be achieved through the utilization of antenatal care services, making budget for pregnancies and childbirth at family level (pending the time every family participates in National Health Insurance Scheme), adequate funding of social welfare services to assist indigent patients, liberal blood donation, and regular training of doctors and nurses on this subject.

Outcome of Breech Deliveries at a Tertiary Health Institution in Southwestern Nigeria.

The aetiology of breech presentation is not clear, however, several factors had been found to be associated with increased risk of breech presentation. The mode of delivery of breech presentation for optimum neonatal outcome had been a subject of controversy over the years. The present study is a retrospective analysis of the outcome of singleton breech delivery at a tertiary health institution. The incidence of singleton breech delivery during the study period was 2.9%. The maternal age ranged between 16 and 44years with a mean age of 30.05±5.53; primiparous were 32(37.2%), while multiparous were 54(62.8%). External cephalic version was attempted, but failed in one case; assisted vaginal breech delivery was conducted in 19(22.0%) cases, 47(54.7%) were delivered by emergency Caesarean section, and 20(23.3%) had elective Caesarean section. Asphyxia was present in 14(77.8%), 31(66.0%) and 8(40.0%), of babies , delivered by assisted vaginal breech delivery, emergency Caesarean section, and elective Caesarean section, respectively (df = 2, p= 0.042). This study showed that elective Caesarean delivery gives the best neonatal outcome for breech presenting fetuses. Booking status positively impart fetal outcome, therefore provision and utilization of good quality antenatal care will go a long way to reduce the incidence of unbooked emergencies that significantly contribute to the poor neonatal outcome in breech deliveries. Key words: breech presentation, mode of delivery, neonatal outcome

Barrier contraception among adolescents and young adults in a tertiary institution in Southwestern Nigeria: A cross-sectional descriptive study

Nigeria, like most African nations, is basically conservative, but the young people are becoming more sexually liberated, and the incidence of STD/HIV, unwanted pregnancies and abortions among these young people is on the increase. The use of barrier contraception (BC), which is a cost-effective method of preventing STD/HIV, unwanted pregnancies and its attending complications, has therefore become an important issue in reproductive health. This descriptive cross-sectional study was carried out among first year students of Osun State University, Nigeria. Four hundred respondents were studied using pre-tested semi-structured questionnaires. The respondents were selected by balloting. Most respondents (93%) had heard about the male condom as a method of barrier contraception. Most respondents (79.1%) supported the use of barrier contraceptives, but many (62.5%) thought it would promote sexual promiscuity, 33.4% believed that the use of barrier contraception reflected a lack of trust from the partner, and 38.7% felt barrier contraception is not necessary with a stable partner. One hundred and sixty one (40.5%) had used a form of barrier contraception before, but only 130 (32.7%) are currently using BC. The male condom was the most commonly used method (88.2%), followed by female condom and diaphragm (5.6% respectively). The prevention of STI and unwanted pregnancies were the main reasons (59%) given by respondents for using BC, while religion was the main reason given by non-users. The attitudes of these students toward barrier contraception and their practice were poor. The role of sex education at homes and religious gatherings cannot be over-emphasized.

Characterization of Staphylococcus aureus isolates obtained from health care institutions in Ekiti and Ondo States, South-Western Nigeria

Staphylococcus aureus is one of the major causative agents of infection in all age groups following surgical wounds, skin abscesses, osteomyelitis and septicaemia. In Nigeria, it is one of the most important pathogen and a frequent micro-organism obtained from clinical samples in the microbiology laboratory. Data on clonal identities and diversity, surveillance and new approaches in the molecular epidemiology of this pathogen in Nigeria are limited. This study was conducted for a better understanding on the epidemiology of S. aureus and to enhance therapy and management of patients in Nigeria. A total of 54 S. aureus isolates identified by phenotypic methods and obtained from clinical samples and nasal samples of healthy medical personnel in Ondo and Ekiti States, South-Western Nigeria were analysed. Typing was based on antibiotic susceptibility pattern (antibiotyping), polymerase chain reaction-restriction fragment length polymorphisms (PCR-RFLPs) of the coagulase gene and pulsed field gel electrophoresis (PFGE). Of the 54 isolates, 50 were confirmed as S. aureus by PCR detection of the nuc gene. The antibiotic susceptibility testing showed that all the isolates were susceptible to fusidic acid and clindamycin, but 100% resistant to penicillin, 70% to tetracycline, 22% to erythromycin, 6% to gentamicin and 4% to ciprofloxacin. Only one isolate was confirmed to be a methicillin-resistant S. aureus (MRSA). The study established the importance of confirming phenotypic identification of S. aureus and MRSA by molecular techniques. There was a high level of agreement between the three methods in the typing of methicillin-susceptible S. aureus (MSSA). Furthermore, the recognition of a predominant MSSA clone from clinical and nasal samples indicates the possible cross-infection from medical personnel to patients. A total of nine of the 50 isolates were Panton-Valentine leukocidin (PVL) positive suggesting that they are community-associated S. aureus isolates. The study provided baseline information on the need for effective infection control measures in health-care institutions in South-Western Nigeria. Key words: Staphylococcus aureus, phenotypic and molecular typing, methicillin-susceptible S. aureus clone

Quality of life of stroke survivors and apparently healthy individuals in southwestern Nigeria

Quality of life (QoL) data have been used to assess treatment outcomes and to guide programme and rehabilitation efforts. QoL data in stroke survivors (SSV) from Nigeria are rare. This study compared the QoL of 84 SSV and 87 matched apparently healthy individuals (AH) in southwestern Nigeria. The effect of poststroke duration (PSD) on QoL and the relationship between QoL and motor performance (MP) were also investigated. SSV were recruited from all (7) tertiary health institutions in southwestern Nigeria. The fifth edition of Comprehensive Quality of Life Adult questionnaire and the Modified Motor Assessment Scale were used to assessed QoL and MP, respectively. Data were analyzed by using Mann-Whitney U-test, Spearman's correlation test, independent t-test, and Kruskaal-Wallis test (α=0.05). The SSV and AH were aged 59.7±11.9 and 60.0±12.1, respectively. SSVs’ mean PSD and MP score were 17.8±15.4 months and 55.3%±18.9%, respectively. Objective QoL of SSV (42±12.8) was significantly lower (p < 0.05) than that of the AH (56.3±6.7). Subjective QoL of SSV (67.8±10.6) was also significantly lower than that of the AH (74.2±6.4). AH had significantly higher QoL than SSV in all but material, intimacy, and safety (subjective and objective) domains. There was no significant relationship between MP and QoL, and PSD had no significant influence on QoL. Our findings suggest that stroke survivors in southwestern Nigeria have lower QoL than their apparently healthy counterparts and may benefit from comprehensive management programmes.

An Investigation into Communication Climate and Staff Efficiency in South-Western Nigeria Tertiary Institutions

This study examined the relationship between communication climate and staff efficiency in selected tertiary institutions in south-western Nigeria. Using the stratified random sampling technique, 1500 workers were drawn from public and private tertiary institutions i.e Universities, Polytechnics and Colleges of Education). The descriptive survey research design was adopted while data were collected via questionnaire tagged Communication Climate and Staff Efficiency Questionnaire (CCSEQ). This questionnaire was also complemented with an interview schedule. Five null hypotheses were generated while the Pearson's product moment correlation and t-test statistics were employed in testing the hypotheses at 0.05 error margins. Plausible recommendations were posited as a result of the findings. Keywords: Communication Climate, Staff, Staff Efficiency, Tertiary Institutions, Organization.African Research Review Vol. 2 (3) 2008: pp. 173-186

Knowledge, attitudes to HIV/AIDS and sexual behaviour of students in a tertiary institution in south-western Nigeria

Objective To determine the knowledge, attitude and sexual behaviour of students in a tertiary institution in south western Nigeria with regard to HIV/AIDS.Methods Descriptive cross-sectional survey conducted between January and March 2005. Information was collected from 368 students of a tertiary institution in Ede, Osun State, Nigeria. Participants were selected by a multi-stage sampling method and data obtained using a semi-structured pre-tested questionnaire.Results Most (89.4%) respondents were aware of the existence of HIV/AIDS, and knew the aetiology, routes of transmission, signs and symptoms, and preventive measures against the disease. While a little over half (59.8%) of the respondents revealed that they could hug people with HIV/AIDS, one out of four (27.2%) stated that these persons should be isolated from the community. Less than a quarter (22.3%) of the respondents believed that they were vulnerable to HIV/AIDS. More than half (58.2%) had ever had sex; the mean age at their first sexual exposure (for all respondents) was 16.7 ± 4.4 years. Almost half (48.2%) of the 191 currently sexually active respondents had multiple sexual partners. Of the sexually active respondents, 75.9% claimed to have ever used condoms; among these, male respondents were more likely to have ever used condoms than their female counterparts (p < 0.05).Conclusion The study revealed a gap in the knowledge of HIV/AIDS and an inappropriate sexual behaviour among respondents. Meaningful strategies, such as an innovative and culturally sensitive adolescent sexual and reproductive health programme that focuses on modification of sexual behaviour should be adopted to allow young people to prevent transmission of the HIV/AIDS virus.

Causes and pattern of death in a tertiary health institution in South Western Nigeria

The study reviewed and analysed the causes and pattern of death among patients admitted to the Federal Medical Centre, Owo in the year 2004.The case note records of all patients that died on admission in the hospital for the year 2004 were reviewed. A total of 104 cases out of the 114 patients that died were reviewed. Total admission was 1819 for the year.Annual death rate was 6.3%. Overall, infectious causes of death was the most common (22.1%) ; this was followed by deaths from pregnancy and neonatal preterm related causes(18.3%) while deaths from neurological disorders (stroke, meningitis, and meningo-encephalitis among others) (17.3%); gastro-intestinal disorders(11.6%), respiratory disorders (10.6%) endocrine disorders (7.7%) and others followed in that order. In the medical wards cerebrovascular disease was the leading cause of death; in Obstetrics and Gynaecology, prolonged obstructed labour was the leading cause of death while Paediatrics and Surgery departments had preterm births and head injuries and multiple fractures as the leading causes of death respectively.Periodic review of hospital deaths could be important in knowing the changing pattern of mortality in our environment. In this study, improvement in the living condition of the citizens, use of potent antibiotics in treating infections and increased patronage of immunisation facilities as ways of control of infections is advocated.

Feto – maternal haemorrhage in parturients: Incidence and its determinants

SummaryThis prospective study of parturients at a tertiary health institution in south-western Nigeria aims to identify the incidence, severity and obstetric factors predisposing to feto – maternal haemorrhage (FMH) in our population. The exclusion criteria were haemoglobinopathy and patient's refusal of consent to participate in the study. The prepared slide was processed as in the acid elution test described by Kleihauer – Betke. The FMH was calculated using Mollison formula (Mollison ). Baseline data included maternal biodata, blood group, RhD and haemoglobin electrophoresis, route/mode of delivery, duration of labour, obstetric interventions, fetal blood group and birth weight. Data generated were analysed with Statistical Package for Social Scientists (SPSS) version 11 software. Frequency tables, cross-tabulations and correlations were performed. Pearson's correlation was applied to continuous variables, while Spearman's correlation was utilised for discrete variables. Level of statistical significance was set at p < 0.05. A total of 163 parturients were studied, of which eight were multifetal gestations. There were no significant differences in maternal age, parity, estimated gestational age at delivery and birth weight, in both groups of parturients with and without FMH. A total of 17 parturients (10.43%), four of which were multifetal gestations (2.45%), had demonstrable FMH. Large FMH (>15 ml fetal cells) were noted in 10 (6.14%) parturients, of which, four were RhD-negative mothers. A total of 9.8% and 11.5% parturients in the vaginal and caesarean delivery groups, respectively, had significant FMH (p = 0.736). Incidence of large FMH was similar with each of the routes of delivery. Antepartum complications of pregnancy, delivery manoeuvres and episiotomy were not significant determinants of FMH. Multiple gestations, fetal birth weight and complications in labour were significantly associated with risk of FMH. Risk-based approach to management, in RhD negative pregnant women, might lead to under-treatment, with attendant increased incidence of isoimmunisation. At least in all RhD-negative women, the cord blood should be tested to determine the baby's blood group and if RhD-positive, Kleihauer – Betke test should be done to determine the degree of FMH and anti-D immunoglobulin dose administered appropriately. Further studies are necessary to establish the determinants/risk factors for FMH.

CRYPTOSPORIDIOSIS IN HIV INFECTED PATIENTS WITH DIARRHOEA IN OSUN STATE SOUTHWESTERN NIGERIA

Aim: Although cryptosporidiosis is said to be rare among adult HIV patients in certain parts of Nigeria, there are no documented studies on the occurrence of this parasite among HIV patients in Southwestern Nigeria. Methods: We conducted a cross sectional study involving 150 patients (100 HIV infected and 50 HIV negative) with diarrhoea from two tertiary and one secondary health institutions in Southwestern Nigeria. Concentrated stool sample from each patient was screened for cryptosporidium oocysts with the modified cold Ziehl Neelsen method while direct sample was screened for other enteric parasites. Results: The overall parasite prevalence rate in the diarrhoea patients is 79.3% (119/150) with Cryptosporidium parvum 52.7%, Ascaris lumbricoides 11.3%, Hookworm 3.3%, Trichuris trichura 2% and Entamoeba histolytica 10%. The parasite prevalence rate in HIV infected patients is 97% while in HIV-negative patients, the rate is 44%. The rate is significantly higher among HIVinfected patients with diarrhoea than among HIV-negative patients with diarrhoea (OR=41.152, 95%CI=11.467-147.68, P<0.0001). However this difference is attributed to Cryptosporidium which was found exclusively among HIV-infected patients. When Cryptosporidium prevalence was excluded from analysis, the parasite prevalence rates between the two groups was not significantly different (X2=0.8002, df=3, P=0.8494). Conclusion: Contrary to a previous report of apparent rarity of cryptosporidium infections in certain parts of Nigeria, this study revealed a high prevalence of this parasitosis among HIV infected patients in Southwestern Nigeria.

A 12-year review of cases of adult tetanus managed at the University College Hospital, Ibadan, Nigeria

In this review, hospital case records of 202 adult tetanus managed between January 1990 and December 2001 in a tertiary institution in Southwestern Nigeria were reviewed. The mean age of the patients was 36.1+/-17.8 years with male:female ratio of 2.2:1 and an overall mortality rate of 64%. Patients with unfavourable outcomes spent 4.5+/-0.41 days compared with 16.6+/-1.2 days by those who survived. Factors associated with poor prognosis are age >60 years (P=0.029), incubation period <7 days (P=0.007), period of onset <48 h (P=0.0001), tachycardia with pulse rate >120/min (P=0.001) and spasm (P=0.002). Gender (P=0.11), post-injury vaccination (P=0.48) and types of antibiotics administered (P=0.49) were not significantly associated with increased mortality. The three most common complications were aspiration pneumonitis, sepsis and urinary bladder obstruction while complications with highest mortality (100%) were sepsis and cardiac arrest.