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Background: Many adolescents are exposed to a significant amount of sexual content in the media. This has far-reaching effects on their sexual practices as this exposure is occurring at a period when most adolescents are often not sure of the choices to make, and the choices they make during adolescence affect their health when they become adults. The aim of this study was to assess the association between exposure of in-school adolescents to sexual content in the electronic media and their sexual intentions.Methods: In this cross-sectional study, information was obtained from 750 senior secondary school students in private and public schools using interviewer-administered questionnaire. Sexual media content in the movies, music video and Internet was assessed using a modified version of the sexual media diet tool. The dependent variable was sexual intention; the main independent variable was exposure to sexually explicit content in the media and confounders that were controlled for selected individual (age, sex, religiosity, self-esteem and attachment to parents), family (parents' marital status, parents' type of marriage, hands-on parenting and parent-adolescent communication on sex) and environmental factors (school connectedness and influence from peers) which were previously reported to be associated with sexual intentions of adolescents. Chi-square test was used to determine associations between sexual content of the electronic media and adolescents' sexual intentions, and confounders were controlled for using logistic regression analysis.Results: Thirty-six percent of respondents were exposed to overtly explicit sexual content from all forms of media in the 3 months prior to this study. Twenty-four percent of the adolescents indicated their intention to have sex within 12 months following the study. Predictors of sexual intention were as follows: moderate [odds ratio, OR=2.21 (95% confidence interval, CI: 1.22-3.99)] and high exposure to sexual content in the media [OR=3.02 (95% CI: 1.69-5.43]; attending a public school [OR=2.19 (95% CI: 1.26-3.83)]; moderate peer pressure [OR=2.36 (95% CI: 1.41-3.95)] and high peer pressure [OR=10.32 (95% CI: 2.94-36.31)]; and previous history of sexual intercourse [OR=3.89 (95% CI: 2.25-6.76)].Conclusion: Many adolescents were exposed to sexually explicit content in the media and this had a strong association with sexual intention. Interventions to censor sexually explicit content in the media are required to protect adolescents from the consequences of early exposure to sex. [ABSTRACT FROM AUTHOR]

This study compared knowledge and compliance with traffic signs among young commercial motorcyclists in rural and urban communities in Oyo state, Nigeria. Information on knowledge and compliance with 10 common traffic signs was obtained from 149 rural and 113 urban commercial motorcyclists aged 18–35 years. Aggregate knowledge scores were computed and categorized as good (≥5) and poor (<5) knowledge. Overall, 98.7% rural versus 61.1% urban motorcyclists had poor knowledge of traffic signs (p< 0.05). After controlling for age, level of education and years of commercial riding, motorcyclists in the rural areas were more likely to have poor knowledge of the traffic signs (OR = 58.15; 95% CI = 11.96–282.79). A higher proportion of rural than urban motorcyclists never obeyed any of the traffic signs. Young rural commercial motorcyclists' knowledge and compliance with the road signs was poorer than their urban counterparts. Interventions to improve the rural motorcyclists' knowledge and ultimately compliance with road signs are urgently required. [ABSTRACT FROM PUBLISHER]

Purpose: To describe the factors that determine the utilization of eye care services in a rural community in South‑Western Nigeria. Methods: A descriptive cross‑sectional survey using a multistage sampling technique was conducted. The main outcome measure was self‑reported previous consultation of an orthodox medical facility for eye care. Results: The study sample included 643 participants. Only 122 (19%) respondents had previously visited orthodox facilities in search of eye care and 24% of those with presenting visual acuity <6/18 had sought eye care. Characteristics associated with previous utilization of eye care services were age of ≥70 years (odds ratio [OR] = 1.7, P = 0.02); male gender (OR = 1.5, P = 0.04); literacy (OR = 1.7, P = 0.007); and residing close to an eye care facility (OR = 2.8, P < 0.001). Blind respondents were three times more likely to seek eye care (P < 0.001). Regression analysis revealed that factors associated with increased likelihood of utilization of eye care services included age ≥70 years; literacy; residence close to an eye facility; being diabetic or hypertensive; history of ocular symptoms, and blindness. Conclusions: These findings suggest that a significant proportion (75%) of adults in the study area are not utilizing eye care services and that blindness is an important determinant of utilization of eye care services. Health education and awareness campaigns about the importance and benefits of seeking eye care early, and the provision of community‑based eye care programs are essential to boost the uptake of eye care services in this community as well as other rural areas of West Africa. [ABSTRACT FROM AUTHOR]

Background: The increasing number of the elderly persons and their attendant health problems has implications on public health programs in developing countries. However, there is limited information on the elderly residing outside major cities in Nigeria. Therefore, this study was conducted to determine and compare prevalent health problems and associated risk factors in the elderly of urban and rural communities in Oyo State, Nigeria. Materials and Methods: A comparative cross-sectional survey of consenting adults aged 60 years and above in Iseyin (urban) and Ilua (rural) communities of Oyo State in south-west, Nigeria. Using cluster sampling technique, a total of 630 respondents; 316 in the urban and 314 in the rural participated. Information was sought on the respondents' socio-demographic characteristics, life style, self-reported health problems. Anthropometric measurements and clinical examination including blood pressure measurements and visual acuity were conducted. Results: The mean age of urban respondents was 72.2 ± 9.5 years compared with 70.8 ± 8.1 years in the rural. There were more females (61.1%) than males (38.9%) in both the locations. Self-reported health problems in both locations were similar and included reduced sexual fulfillment, musculoskeletal problems such as muscular and low back pain. On clinical examination, the main health problems were visual impairment 58.7% in the urban versus 41.7% in the rural (P < 0.001). Prevalence of hypertension among urban and rural respondents was 38.3% and 34.7%, respectively (P = 0.35). Osteoarthritis was significantly higher 8.5% in urban than 3.2% obtained in rural (P = 0.004v). On multivariate analysis, female gender, increasing body mass index, and low monthly income were significant predictors of hypertension in both locations. Conclusions: Cardiovascular, musculoskeletal, and visual noncommunicable diseases were prevalent in both elderly populations. Social conditions and gender play important role in the health status of the elderly. [ABSTRACT FROM AUTHOR]

Objective: The main objectives of the study were to determine the relationship between social network and pathway to service utilization among psychotic patients. Materials and Methods: This descriptive study was carried out in a psychiatric unit in a general hospital in South West Nigeria. Using structured questionnaires, primary data were collected from 652 psychotic patients on their social network, health behaviors and pathway to current service use. Logistic regression analysis was used to assess the effect of social network on patients' use of services, controlling for sociodemographics, health and functional status. Results: Mean age of the respondents was 29.0 ± 7.5 years, range 14-58 years, males constituted 52.6%. Regarding pathway to services, alternative sources of care such as priests, spiritualists, natural therapists, herbalists, was the first port of call for 78.9% of respondents. Family dominated the social network in 51.1% of patients. The presence of some social network and social support structures were significantly associated with the use of general medical and specialty psychiatric services for patients with schizophrenia (P = 0.03), schizoaffective disorder (P = 0.02), bipolar I disorder (P = 0.01), but not with major depression and symptoms of psychological distress. Conclusions: Findings indicate that social support and social network enhanced utilization of mental health services for psychiatric patients except for those with psychotic depression or those with symptoms of psychological distress. In addition, alternative sources of care are still relevant in mental health service delivery in South West Nigeria. [ABSTRACT FROM AUTHOR]

The increasing prominence of patent medicine vendors (PMVs) in healthcare provision makes information about how they operate of interest. This study assessed consumers' behavior and PMVs' performance in the treatment of childhood illnesses in rural and urban communities in South West Nigeria. Non-participatory observations were carried out in 163 licensed patent medicine stores in Oyo State, Nigeria. Many PMV shops (70.6% rural and 61.9% urban; p = 0.141); stocked non proprietary drugs. Clients often requested for drugs by name (75.4% urban versus 62.2% rural; p = 0.002) and PMVs mostly sold drugs as requested without questions (65.3% urban 57.8% rural; p = 0.07). Inappropriate treatment practices and invasive procedures were observed more often in urban PMVs shops (p < 0.001). PMVs functioned mostly as sales persons supplying clients' drug requests. Strategies to improve PMV treatment practices should include caregiver education to be effective. [ABSTRACT FROM AUTHOR]

Introduction: Out-of-school adolescents are often neglected when planning for tobacco prevention programmes whereas they are more vulnerable. Few studies exist in Nigeria about their pattern of tobacco use to serve as the basis for effective policy formulation. Method: A sub sample of 215 out of school adolescents was analyzed from a descriptive cross sectional study on psychoactive substance use amongst youths in two communities in a Local Government Area in Nigeria which used a multi-stage sampling technique. Results: Males were 53% and females 47%. Only 20.5% had ever used tobacco while 11.6% were current users. Males accounted for 60% of current users compared to 40% amongst females. Of current users, 84% believed that tobacco is not harmful to health. In addition, the two important sources of introduction to tobacco use were friends 72% and relatives 20%. Use of tobacco amongst significant others were: friends 27%, fathers 8.0%, relatives 4.2% and mothers 0.5%. The most common sources of supply were motor parks 52% and friends 16%. Conclusion: The study showed that peer influence is an important source of introduction to tobacco use while selling of tobacco to adolescents in youth aggregation areas is common. We advocate for a theory based approach to designing an appropriate health education intervention targeted at assisting adolescents in appreciating the harmful nature of tobacco use in this locality. A point-of-sale restriction to prevent adolescent access to tobacco in youth aggregation areas within the context of a comprehensive tobacco control policy is also suggested. However, more research would be needed for an in-depth understanding of the tobacco use vulnerability of this group of adolescents. [ABSTRACT FROM AUTHOR]

The sexual harassment experiences of female graduates from tertiary institutions in Nigeria, were explored using self-administered questionnaires. Information was obtained on the respondents' socio-demographic characteristics and experiences of sexual harassment while in their various tertiary institutions. The majority (69.8%) of the respondents had been sexually harassed, with the main perpetrators being male classmates and lecturers. About two-thirds experienced the non-physical type of sexual harassment; 48.2% experienced the physical type. Non-physical harassment included sexual comments (57.8%) and requests to do something sexual in exchange for academic favors (32.2%). Physical forms of sexual harassment included unwanted sexual touching (29.4%) and being intentionally brushed against in a sexual way (28.9%). The effects experienced by victims were depression and perceived insecurity on campus. Sexual harassment is a common occurrence in Nigerian tertiary institutions. Appropriate institutional interventions should be developed to reduce these occurrences. [ABSTRACT FROM AUTHOR]

The determinants of hypertension in West Africa have not been well defined. The authors sampled 598 participants aged 45 years or more from a recent population-based survey in southwest Nigeria (190 rural men and women, 205 urban poor men and women, and 203 retired railway workmen). The estimated mean age was 61 (10) years. Mean pressures were low relative to westernized societies: systolic blood pressure = 124 (24) mmHg, diastotic blood pressure = 72 (13) mm Hg. Both men and women were remarkably lean: body mass index = 21.3 (3.6) and 23.0 (5.2) kg/m2, respectively. Hypertension prevalence increased across the gradient from rural farmers to urban poor to railway workers: 14, 25, and 29 percent, respectively, had a blood pressure of 140/90 mmHg or greater, and 3, 11, and 14 percent, respectively, had a blood pressure of 160/95 mmHg or greater (p for trend ± 0.01 for both cutpoints). On the basis of a 24-hour urine sample, daily electrolyte excretion was 110 (57) mEq of sodium and 46 (24) mEq of potassium. Mean sodium: potassium ratio was 2.6 (1.0) and was higher among the urban residents (p±0.01) and correlated with systolic and diastolic pressures (r = 0.16–0.18, p ± 0.01). These findings provide quantitative estimates of the impact of known hypertension risk factors in West Africa and demonstrate the basis for increased prevalence with urbanization and associated economic and dietary change. These results also provide support for recommendations for prevention in West Africa and provide a benchmark against which to compare populations in the African diaspora. Am J Epidemiol 1996; 143: 1203–18. [ABSTRACT FROM AUTHOR]

Urban slum residents have access to a broad range of facilities of varying quality. The choices they make can significantly influence their health outcomes. Discrete Choice Experiments (DCEs) are a widely-used health economic methodology for understanding how individuals make trade-offs between attributes of goods or services when choosing between them. We carried out a DCE to understand these trade-offs for residents of an urban slum in Ibadan, Nigeria. We conducted 48 in-depth interviews with slum residents to identify key attributes influencing their decision to access health care. We also developed three symptom scenarios worded to be consistent with, but not pathegonian of, malaria, cholera, and depression. This led to the design of a DCE involving eight attributes with 2-4 levels for each. A D-efficient design was created, and data was collected from 557 residents between May 2021 and July 2021. Conditional-logit models were fitted to these data initially. Mixed logit and latent class models were also fitted to explore preference heterogeneity. Conditional logit results suggested a substantial Willingness-to-pay (WTP) for attributes associated with quality. WTP estimates across scenarios 1/2/3 were N5282 / N6080 / N3715 for the government over private ownership, N2599 / N5827 / N2020 for seeing a doctor rather than an informal provider and N2196 / N5421 /N4987 for full drug availability over none. Mixed logit and latent class models indicated considerable preference heterogeneity, with the latter suggesting a substantial minority valuing private over government facilities. Higher income and educational attainment were predictive of membership of this minority. Our study suggests that slum residents value and are willing to pay for high-quality care regarding staff qualifications and drug availability. It further suggests substantial variation in the perception of private providers. Therefore, improved access to government facilities and initiatives to improve the quality of private providers are complementary strategies for improving overall care received., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Fayehun et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Globally, over 40 million people were displaced as a result of wars and violence due to religious and ethnic conflicts in 2015 while 19.2 million were displaced by natural disasters such as famine and floods. In Africa, 12 million people were displaced by armed conflict and violence and there were hundreds of thousands of people displaced by natural disasters. Despite these large numbers of internally displaced persons (IDPs) in Sub-Saharan African countries and the potentially negative impact of displacement on the health of these populations, there is limited information on the health problems of IDPs in the region. The previous studies have mainly focused on the health problems of refugees and single disease entities among IDPs. However, a more comprehensive picture is required to inform the provision of adequate healthcare services for this vulnerable population. The objective of this review was to fill this knowledge gap. Bibliographic databases were searched and screened, and nine studies were selected and reviewed. The major physical health problems and symptoms were fever/malaria (85% in children and 48% in adults), malnutrition in children (stunting 52% and wasting 6%), malnutrition in adult males (24%), diarrhoea (62% in children and 22% in adults) and acute respiratory infections (45%). The prevalent mental health problems were post-traumatic stress disorder (range: 42%-54%) and depression (31%-67%). Most of the studies reviewed focused on mental health problems. Limited evidence suggests that IDPs experience various health problems but more research is required to inform the provision of adequate and comprehensive healthcare services for this group of individuals.

Adherence to HAART is necessary to achieve the best virologic response and lower the risk of drug resistance amongst People living with HIV/AIDS (PLHIV). However, there is limited documentation of adherence amongst patients on HAART in the south-south region of Nigeria. This study aimed to determine the prevalence and determinants of adherence to HAART amongst PLHIV in a rural setting in Cross River State. A descriptive cross-sectional study was conducted among 393 patients on HAART attending the Heart to Heart centre Ugep using an interviewer-administered questionnaire. Adherence was measured via self report and patients were termed adherent if they took at least 95% of prescribed doses. The self reported adherence rate based on a one week recall was 50.4%. The main reason for skipping doses were being busy (50.6%), simply forgetting to take medications (43.8%) and religious constraints (16%). Perceived improved health status [OR 2.7; CI: 1.37-5.39], Non use of herbal remedies, [OR 1.8; 95% CI: 1.23- 2.64] and ARV regimens devoid of dietary instructions [OR 1.49; 95% CI: 1.07- 2.06] were significant predictors of adherence. The adherence rate reported in this study was low. Appropriate adherence enhancing intervention strategies targeted at use of simplified ARV regimens and discouraging herbal use is strongly recommended.

Background: The concept of the street child in rural communities has received little attention. This study describes the sociodemographic characteristics of the street children found in a group of rural communities., Method: This descriptive study is nested in a cross sectional analytical study of street children in a group of rural communities undergoing urbanization. A cluster sample of street children as defined by the United Nations was taken in the seven chosen political wards., Results: Majority of the street children (88.9%) were within the age group 15-17 years with more males (58.3%) than females (41.7%). Up to 64.7% had attained secondary level education while only 3.9% had no formal education. A high percentage, (61.4%) were still attending school and 15.8% had no work. Of those who work on the streets, being an apprentice (16.4%), petty trading (15.0%), part-time driving (9.5%) and car washing (5.0%) were the commonest types of work. Of those still schooling, 41.6% had no form of part-time work on the streets. None of the street children lived on the street with 65% still living with parents. However, 75% had been involved in the street life for 1-2 years with a median time of 2 years. More than 30% of their parents work outside town., Conclusion: The street child in rural communities differs from the urban perception which often has to do with those living rough and existing outside the family framework. More studies would be needed on the driving factors for street life in rural communities undergoing urbanization.