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Vitalis C Okwor,1,2 Adeniyi F Fagbamigbe,1 Olufunmilayo I Fawole1 1Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria; 2Department of Radiation Medicine, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria Background: Head and neck cancer (HNC) is a major clinical and public health concern worldwide which impairs the vital functions of life. The treatment of metastatic HNCs is mainly palliative. This study examined the survival patterns and treatment outcomes in patients with HNCs in a tertiary hospital in Nigeria.Materials and methods: A review of the case files and treatment cards of patients with histological diagnosis of HNCs seen between January 2002 and December 2011 at the Radiotherapy Department, University College Hospital, Ibadan, was conducted. A total of 494 cases were identified, of which 481 had valid records. Analyses were done using Kaplan–Meier survival function and Cox proportional hazard regression techniques at 5% significance level.Results: The median age of patients was 42years with a male-to-female ratio of 2:1. Most patients presented at stages 3 (50.7%) and 4 (36.8%). Nasopharyngeal carcinoma was the most common (42.6%) HNC, followed by paranasal sinus (17.7%) and laryngeal cancer (11.6%). The lung was the most common site of metastasis (25.5%). Patients who presented at stages 1 and 4 disease had a median survival of 7.8years and 1.9years, respectively. Patients treated with a combination of chemotherapy and radiotherapy had a median survival of 8.0years compared with those who had a single modality of treatment (~6.3years).Conclusion: Patient survival was inversely proportional to the stage of the disease. To encourage the early presentation of HNC cases, health education of the population on routine medical check-ups and on the symptoms suggestive of HNC is recommended. Health care providers should be trained to refer suspected cases promptly to tertiary health facilities for management. Keywords: head and neck cancer, treatment outcome, survivorship patterns&nbsp

Olusola Olawoye,1 Olufunmilayo I Fawole,2 Christopher C Teng,3–5 Robert Ritch4,5 1Department of Ophthalmology, University College Hospital Ibadan, Nigeria and College of Medicine University of Ibadan, Ibadan, Nigeria; 2Department of Epidemiology, Medical Statistics and Environmental Health, College of Medicine, University of Ibadan, Nigeria; 3Department of Ophthalmology, New York University Langone Medical Center, New York, NY, USA; 4Einhorn Clinical Research Center, The New York Eye and Ear Infirmary, New York, NY, USA; 5New York Medical College, Valhalla, NY, USA Purpose: To evaluate the relevance of community eye outreach programs in the early detection of glaucoma patients in southwest Nigeria. Methods: This was a retrospective, cross-sectional study that was conducted among glaucoma patients referred to the eye clinic of the University College Hospital (UCH), Ibadan, Nigeria, between January 2009 and December 2010 from different sources, including community eye outreach programs. The source of referral, stage of glaucoma, and visual field were recorded. Results: Six hundred and fifty-three patients were studied during this period. The mean age was 56.3 years ± 16.6 years, with a median age of 60 years. Patients referred from eye outreach programs were more likely to have mild to moderate disease than patients referred from other sources, who were more likely to have severe disease according to both the optic nerve head assessment (P < 0.01, Pearson's Chi-square = 10.67, odds ratio = 1.7 [confidence interval = 1.23–2.31]) and visual field assessment (24-2) (P < 0.01, Pearson's Chi-square = 6.07, odds ratio = 1.5 [confidence interval = 1.08–2.03]). Conclusion: Community eye outreach programs appear highly useful in the earlier detection of glaucoma in sub-Saharan Africa. Keywords: community eye outreach, early glaucoma detection, Nigeria glaucoma detection, glaucoma awareness, sub-Saharan Africa.

Ifeoluwapo O Asekun-Olarinmoye,1 Esther O Asekun-Olarinmoye,2 A Fatiregun,3 Olufunmilayo I Fawole3 1Department of Public Health, School of Public and Allied Health, Babcock University, Ilishan-Remo, Ogun State, Nigeria; 2Department of Community Medicine, College of Health Sciences, Osun State University, Osogbo, Osun State, Nigeria; 3Department of Epidemiology, Medical Statistics, and Environmental Health, College of Medicine, University of Ibadan, Oyo State, Nigeria Introduction: The epidemic of human immunodeficiency virus (HIV) continues in Nigeria despite efforts to control it. Meaningful efforts aimed at combating this disease must be multisectoral. However, despite the major influence religious leaders have in this society, their role has not been well studied. The aim of the study was to assess the perceptions and activities of religious leaders on prevention of HIV/acquired immunodeficiency syndrome (AIDS) and care of people living with the virus in Ibadan, Nigeria. Materials and methods: In a cross-sectional study, 336 leaders from eight religious denominations in Ibadan were surveyed utilizing a self-administered, semi-structured questionnaire. Respondents were selected by cluster sampling technique. Data was analyzed using the Statistical Package for Social Sciences software version 15. Results: The mean age of respondents was 37.9 (± 13.5) years. The majority (97.6%) were aware of the HIV/AIDS scourge, and most had good knowledge of routes of transmission and modes of prevention (85.7%). Attitudes to people living with HIV/AIDS were positive in 84.2% respondents, and many practiced preventive measures (94.9%). One hundred and ninety (56.5%) respondents had ever preached about HIV/AIDS transmission and treatment to their congregations, while 257 (76.5%) used their position as a medium of educating their congregation about the dangers of HIV/AIDS and how to prevent it. Further analysis showed that respondents who were Christians (P = 0.026), had ever been married (P = 0.004), and were males (P = 0.002) were more likely to have ever preached about health issues to their congregations (individual role). Conclusion: The study concluded that the religious leaders are well informed about HIV/AIDS and have adequate knowledge and positive attitudes towards people living with AIDS. However, they need encouragement and training to enable them to more effectively harness their position for HIV prevention and to control programs and activities among their congregation to thereby play a crucial role in the war against HIV/AIDS in Nigeria. Keywords: faith-based organizations, HIV/AIDS care, perception, prevention, religious leaders

Background: Intimate partner violence (IPV) is an important public health issue that is associated with adverse sexual and reproductive health outcomes including sexually transmitted infections (STIs). STIs have recently gained more recognition worldwide because they increase the risk forHIV infection. However, there is dearth of information on the association between IPV and STIs particularly among married women in Nigeria.Objective: To determine the association between IPV and STIs among married women in Nigeria.Method: This was a secondary data analysis of the 2008 Nigeria Demographic and Health Survey (NDHS) dataset. A total of 18,402 married women aged between 15 and 49 years were included. Questions about intimate partner violence were adapted from the Conflict Tactic Scale (CTS). Multiple logistic regression models were used to determine relationship between IPV and self-reported STIs.Results: The prevalence of IPV among married women in Nigeria was 29.3%. Majority of the women experienced emotional violence (22.1%), 17.3% of the women experienced physical violence while the least experienced form of violence was sexual IPV (4.4%). Majority (60.1%) of the women experienced just one type of IPV, 30.0% two types, 9.9% all three types. The prevalence of selfreported sexually transmitted infections was 7.2%. Logistic regression demonstrated that after controlling for other covariates, women who experienced any form of IPV were found to be more likely to report STI than women who did not [OR 1.357 (95% CI 1.188-1.551)]. In addition, experience of physical and sexual IPV was significantly associated with history of STIs [OR 1.699 (95% CI 1.420-2.034); OR 1.414 (95% CI 1.085-1.843) respectively]. Experiencing two or more types of IPV was significantly associated with history of STIs [OR 1.759 (95% CI 1.446-2.139); OR 2.193 (95% CI 1.636-2.941) respectively].Conclusion: There is a need to incorporate IPV screening and services in STI clinics. Also, it is important to screen for STIs among women who present with IPV particularly those with multiple types of violence.Keywords: Intimate Partner Violence (IPV), Sexually Transmitted Infections (STIs), married women, Nigeria

Context: Promotion of relevant research in reproductive health and dissemination of research findings are the principal goals of the Tropical Journal of Obstetrics & Gynaecology (TJOG), the official publication of the Society of Gynaecology and Obstetrics of Nigeria (SOGON). The ultimate objective of research is to influence practice by employing appropriate study design to answer research questions.Objective: To evaluate the pattern of study designs and range of scientific research in TJOG between 1998 – 2007.Method: The Methods section of all articles published during the study period were reviewed to document the type of study design and research focus. Articles were classified as Commentary/Review, Case Report,Crosssectional Study, Case-Control Study, Cohort Study, Randomised Controlled Trial and Systematic Review as appropriate.Results: Eleven issues from nine volumes comprising of 918 papers were examined. There were 55 commentaries and 4 review articles. There were 95 case reports constituting 10.3% of the 859 research papers. Cross-sectional studies formed the largest category of publications, accounting for 82.5%. Case-control studies (37 - 4.3%), cohort studies (3 - 0.4%) and randomized controlled trials (15 - 1.8%) constituted the rest. There was no systematic review. Maternal and perinatal medicine was the commonest area of research (46.4%). Publications in other subspecialtieswere limited.Conclusion: Most of the research publications were descriptive; experimental research designs were few. Urgent steps are needed to promote diversity in research designs and coverage of all aspects of reproductive health. Concrete actions to increase research activities and improve quality of scientific writing in Nigeria and other tropical countries are urgent imperatives.Keywords: Study design; sub-specialisation; tropical; sub-Saharan Africa