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Purpose : During adolescence, a female child makes several decisions, and the choice to breastfeed in the near future is conceivably shaped. But in sub-Saharan Africa where teenage pregnancy and teenage motherhood is on the rise, there is a dearth of information on the intention of adolescents to exclusively breastfeed (EBF) in community settings. Therefore, this study assessed exclusive breastfeeding intentions, knowledge and attitude of adolescents in urban communities in Ibadan, Nigeria. Methods : A descriptive community-based cross-sectional study was carried out, selecting 271 respondents. Data were analysed with the aid of IBM SPSS version 21 at P ≤ .05. Results : Mean age of adolescents was 17.5 ± 1.3 years, and 96.3% would breastfeed their children later in future. However, only 37.6%, 22.5% and 50.2% had the intention to exclusively breastfeed, good knowledge score and positive attitude, respectively. There were significant relationships between respondents' age, educational attainment, parents' educational attainment, level of knowledge, attitude and intention. The coefficient of knowledge and attitude were significant predictors of good intention to practise EBF. Major predictors of good intention were good knowledge [OR = 36.5; 95% CI (9.2, 145.2)] and positive attitude toward EBF [OR = 9.7; 95% CI (3.6, 25.9)]. Conclusions : The EBF intention was influenced by multiple factors and should be considered in determining the effectiveness of interventions targeting this practice. Therefore, coherent EBF education interventions that commence from adolescence to promote the practice by adulthood are urgently needed to improve knowledge, attitude and intention about EBF rate and confer the cancer-risk reducing benefits.

Introduction: disparity between the demand for and the supply of organs for transplantation remains a major public health issue of global concern. This study evaluated the knowledge and determinants of willingness to donate organs among outpatient clinic attendees in a Nigerian teaching hospital., Methods: a 43-item semi-structured interviewer-administered questionnaire was designed to assess awareness and willingness of individuals attending Neurology, Psychiatry and Geriatrics Outpatient clinics to donate bodily organs for transplantation. Association between participants' characteristics and willingness towards organ donation was investigated using logistic regression models., Results: a total of 412 participants were interviewed and mean age was 46.3 (16.1) years. There were 229 (55.6%) females and 92.5% had at least 6 years of formal education. Overall, 330 (80.1%) were aware of donation of at least one organ for transplantation purposes but only 139 (33.7%) were willing to donate organ. In analyses, adjusting for sex, marital status, family setting and educational status, male gender AOR [2.066(1.331-3.2016)] secondary education [AOR 5.57 (1.205-25.729) p= 0.028] and post-secondary education [AOR-6.98 (1.537-31.702) p= 0.012 were independently associated with willingness towards organ donation., Conclusion: the survey revealed high level of awareness but poor willingness towards organ donation among older Nigerians attending outpatient clinics of a premier tertiary hospital. Male gender and educational attainment were significantly associated with willingness to donate. Educational programs that particularly target women and less educated older Nigerians are needed to promote organ donation in Nigeria., Competing Interests: The authors declare no competing interests., (Copyright: Rufus Olusola Akinyemi et al.)

Background: Cervical Cancer (CC) is the second most common cancer among women with early detection and prompt treatment as best management options. Female nurses have crucial roles to play in promoting the utilization of Cervical Cancer Screening Services (CCSS), yet little information exist regarding their perception and utilization of these services. The CCSS related knowledge, perception and utilization among female nurses at the University College Hospital, (UCH) Ibadan, Nigeria were therefore determined., Methods: A survey of 503 consenting nurses was done using a pretested self-administered questionnaire which included a 40-point knowledge scale and questions on perception of CC. Data were analyzed using descriptive statistics, Chi-square test, ANOVA and logistic regression., Results: Respondents' mean age was 38.0 ± 8.6 years, mean year of experience was 12.5 ± 8.9 years and overall mean knowledge score was 22.8±4.1. Mean knowledge scores by cadre were Assistant Directors (26.7 ± 1.5), Chief Nursing Officers (23.4 ± 2.3) and Staff Nurses (21.7 ± 5.3) (p<0.05). Eighty-eight percent correctly perceived CC to be preventable and 82.0% believed that screening should be carried out as soon as sexual intercourse starts irrespective of age. Only 32.6% had ever used CCSS facility and main reasons for non-use included lack of time (50.8%), fear of result (13.9%) and not being sexually active (6.3%). Staff Nurses were four times less likely to utilize cervical screening services than the Assistant Directors of Nursing (OR 0.23, CI 0.117-0.442)., Conclusion: Utilization of cervical cancer screening services among the female nurses was poor. Strategies that encourage utilization are hereby advocated.

This study determined the factors associated with gender based violence among 3000 men and women in selected states in Nigeria. Respondents who had experienced physical violence were 806 (26.9%), comprising 353 (11.8%) males and 453 (15.1%) females (p<0.001). Respondents who had experienced sexual violence were 364 (12.1%) of which 221 (7.4%) were males and 143 (4.8%) were females (p<0.0001). Married female respondents were more likely to experience physical violence than single respondents (OR= 1.71, 95%CI: 1.15-2.53 p=0.008). In addition, lower risk of experiencing sexual violence among males was observed among those who do not drink alcohol. The study has shown that gender based violence still constitutes a problem in Nigeria, affecting women more than men. However, efforts should be geared towards addressing the factors that promote violence among both sexes through increased awareness and education.

The study explored why actions for early treatment of febrile illnesses in children are delayed by caregivers of children less than five years in five Local Government Areas (LGAs) of southwestern Nigeria using four indicators: caregivers' perception of illness, notion of causation and seriousness, belief in efficacy of selected pathway, and the decision making process. Seven types of febrile illnesses (yellow fever, typhoid fever, ordinary fever/malaria, hot body fever, rain fever, cold fever, and headache fever) were identified and yellow fever was perceived as the most severe type (60.8%). Only 24.2% correctly identified an infected mosquito bite as the cause of ordinary fever/malaria. Use of leftover drugs at home (55.6%) was the main action taken and fathers were the main decisionmakers in all cases. Empowerment of women for improved knowledge on causation, severity, and importance of prompt action for a healthy outcome is recommended.

This study assessed the attitude of unmarried youths towards Mandatory Premarital HIV Testing (MPHT) in Ibadan Northwest Local Government Area. A three-stage sampling technique was used to select 571 unmarried youths from households. A validated questionnaire was used for the collection of the data. Descriptive, Chi-square statistics and logistics regression were used to analyze the data. Mean age of respondents was 20.6 +/- 2.6 years, 52.0% were males and 52.7% had completed their senior secondary education. Though 82.8% believed that MPHT could reduce the spread of HIV, 43.8% stated that it will increase the stigma associated with HIV infection. Attitude towards mandatory pre-marital HIV testing however was positive. Males were about two times more likely to have positive attitude towards mandatory pre-marital HIV testing (OR = 1.507, CI = 1.067-2.129). Positive attitude towards MPHT among study respondents offers a window of opportunity of undergoing HIV testing before marriage.

Background: There is a growing concern that barbering procedures could create opportunities for HIV transmission. However, little is known about Nigerian barbers' practices relating to the prevention of HIV., Objectives: This study assessed the precautionary measures for the prevention of HIV among commercial barbers in Ibadan, Nigeria., Methods: Data were collected using validated checklist to directly observe ninety barbering procedures in forty-five barber shops randomly selected from three communities that have been categorized as inner-core, transitory and peripheral., Results: Respondents were all males with mean age of 36(±10.2) years. Ninety-eight percent had at least primary school education and all of them learnt barbering through apprenticeship. The instruments used were razor blades (11.1%), manual clippers (8.9%) and electric clippers (80%). Clippers were sterilized in 10% and disinfected in 72.5%, while no decontamination was carried out in 17.5% of the sessions. Fifty two percent of the disinfections involved the use of kerosene, a disinfectant not recommended for HIV inactivation; 48.3% of the disinfectants were not in the original containers while 53.4% of the sessions involved the use of same brush for cleaning clipper and brushing hair. Hand-held flame and Ultra-violet light sterilizer were used in 50% of the sterilization process. Barbers in the high-class peripheral communities were more likely to practice appropriate equipment decontamination than those from lower-class inner-core communities. There was blade-to-skin contact in all and accidental cuts occurred in three of the sessions and none was properly managed., Conclusion: The risk of transmitting HIV is high in the barbershops in the study area. Health education strategies such as training, supportive supervision and peer education are needed to facilitate the adoption of effective precautionary measures against HIV infection among barbers.

The study explored home management practices for malaria by caregivers in the Military Cantonment, Ojo Lagos. Data was collected using pre-tested Focus Group Discussion guide and interviewer-administered questionnaire. The 400 survey respondents were selected using the systematic sampling method while the discussion participants were purposively selected. Data analysis was done using EPI Info statistical software and thematic approaches. The mean age of respondents was 29 +/- 15.2 years while 89.8% of respondents were biological parents of the index children. High prevalence of malaria all year round caused by mosquitoes bite was indicated by 281 (70.2%) respondents, while 73 (18.3%) of the respondents reported having lost a child under 5 years old to malaria related illnesses. Preventive practices were uncoordinated while awareness and use of ITNs is low. Home management practices of childhood malaria involved the immediate treatment with medicines available in the home. Sharing of left over drugs and herbs were common practices. Home treatment was preferred because of high costs 250 (62.5%), unfriendly attitude of workers 195 (48.8%) and long waiting time 194 (48.5%) in the health facilities. Based on the findings there is the need to institute an awareness programme aimed at improving prompt home management of malaria in the barracks.

Objectives: Our goals were to train health professionals in Nigeria using the text, "Planning and Implementing Cervical Cancer Prevention and Control Programs: A Manual for Managers", and then evaluate the knowledge dissemination process using a pre- and post-test assessment. The manual was developed by the ACCP, WHO, IARC, PATH, Engender Health, JHPIEGO, and PAHO with funding from the Gates Foundation. It is an inclusive guide to implementation and maintenance of screen-and-treat cervical cancer prevention clinics and is ideally suited for programs operating in the developing world., Methods: Training took place at a conference in Ibadan, Nigeria. Participants included teams of physicians, nurses, bioengineers, data managers, and administrators who met in joint and parallel sessions to "train the trainers". This meeting was designed to provide both training and equipment to personnel to be involved in the implementation of a cervical cancer control initiative in Nigeria. A 36 item pre-test was administered prior to a group study sessions. A slide presentation summarized salient points before the post-test was given. The results were entered into an MS Excel spreadsheet for descriptive statistics about (1) the participants, (2) the test, (3) an examination of profession, years of work experience, years of education, and gender as predictors of two outcomes (low pre-test score and large difference between pre- and post-tests) and (4) overall performance on the exam., Results: There were 70 participants and trainers, of which 53 took the exam. Most of the examinees were physicians. Some participants did not fill out the post-test, leaving their tests inevaluable. A closer look at the test revealed eight questions that were confusing and nine that were too easy. All participant subgroups performed better on the post-test than the pre-test; the improvements were statistically significant. While profession impacted the results, profession was not statistically significant. Years of work experience, years of education, and gender did not affect test results., Conclusions: While the study suffers from a small sample size, a few ambiguous questions, and the need for pilot testing the instrument prior to the meeting, the report evaluates the manual very favorably. The authors showed a significant gain in knowledge. The manual gives "the big picture" and does so with clarity. The text and supplementary material outline the work that needs to proceed in an organized program, and the material was easily understandable in Nigeria. Future evaluations could benefit from more participants and varied learning structures.

Each year, around half a million children aged under 15 become infected with HIV and more than 90% are the result of mother-to-child transmission. Services to prevent mother-to-child HIV transmission (PMTCT) are therefore important entry points for HIV/AIDS prevention, treatment and care services for women, their children and families. The study aimed at identifying level of awareness and knowledge of PMTCT services that can be utilized in improving access. The methodology consisted of 20 individual in-depth interviews spread over Adabeji, Adeoyo/Agbadagbudu, Jakiru/Onipasan and Eleta communities, in Ibadan among household heads, religious and community based leaders. Key factors identified were low knowledge of mother to child transmission, lack of knowledge of the PMTCT services, inadequate community sensitization, inadequate healthcare facilities. The success of PMTCT programmes demands a shift towards a more community-based approach which calls for strong advocacy, enlightenment and community mobilization for improved awareness and utilization of PMTCT services.

Polio immunisation has faced challenges of refusal from care givers in recent times despite the efforts put in to ensure its success. To identify the role of service providers in this attitudinal shift, a survey describing the perception of health workers about the supplemental immunization activities was carried out among 265 health workers who participated in the 3rd round of the 2003 sub-national immunization days in Gombe local government area (LGA) of Gombe state, Nigeria. Data was collected using pretested qualitative and quantitative instruments. Quantitative data was analysed using EPI Info statistical software and the qualitative using thematic areas. Results showed that 211 (79.6%) knew fecal-oral route as the commonest mode for poliovirus transmission, 231 (87.2%) knew the age for vaccination, 224 (84.5%) knew the correct use of vaccine vial monitor while 143 (53.9%) knew the correct action to take when a case of polio was identified. On perception, 22 (8.3%) perceived that OPV was harmful due to repeated administration, 26 (9.8%) perceived that OPV had sterility property, contained harmful materials 14 (5.3%) and HIV 11 (4.2%). Main reasons for immunisation rejection were sterility 115 (43.3%) and contamination with HIV 94 (35.5%). The study found that irrespective of adequate knowledge on transmission, misconceptions still exist among health workers on the polio vaccine. Based on this, there is the need for continuous training to remove the misconceptions concerning their perceptions and rumors about the vaccine and the programme.

Traditional healers play an important role in the provision of healthcare in many communities in Africa. This study aimed to improve home management of malaria in children by assessing the healer's knowledge and practice. A semi-structured questionnaire interview of 127 traditional healers selected by proportionate sampling technique from two rural and two urban local government areas (LGAs) of southwestern Nigeria was followed by a training program. Malaria ranked first (87%) among the illnesses managed by the healers. Diagnosis of fever was often (72%) based on client history, physical examination (24.4%), consulting oracles (18.9%), and interpretation of dreams (3.1%). Treatment of malaria was with boiled herbs ("agbo"; 72%), ground herbs ("agunmu"; 14%), and incisions and scarifications (3%). Forty-one (32.5%) healers had referred febrile children to a health facility. Younger healers and those who had at least a secondary education were more likely to refer patients (p < 0.05 in both cases). Thirty-six healers (28.4%) had previous formal training on management of fevers, most of whom were the younger (p < 0.05), educated healers (p > 0.05), with fewer years of practice (p > 0.05). Research into traditional herbs (48%), better acknowledgment by government (23.6%), and collaboration with other health sectors were suggestions to improve practice. Traditional healers, especially the older, less-educated, and long-practicing healers, urgently require formal training and collaboration with other healthcare providers to improve knowledge and promote early referral of children with fever.