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Background:

Despite the recognition of stigma as a hindrance to public health treatment and prevention there are gaps in evidence on the relationship between HIV stigma and VCT services utilization in Nigeria. The purpose of this study was to examine a community’s perceptions, feelings and attitudes towards people living with HIV/AIDS and how this is associated with access to utilization of voluntary counselling and treatment in Nigeria. Methods: A cross-sectional random study of Nigerians, using a mixed-method approach was carried out in two distinct ethnic areas of the country. Both quantitative and qualitative methods (mixed-methods) were used to collect data in Osun State (Yoruba ethnic group) in the South-West and Imo State (Igbo ethnic group) in the South East. Multivariate logistic regression was the model used to examine the association of interest. Results: It is shown that Nigerian public attitudes to HIV/AIDS and those infected with the disease are negative. The markers for stigma on the overall stigma index are significant predictors of utilization of voluntary counselling and testing. As the sum of negative feelings increases, there is less likelihood to using voluntary counselling and testing (VCT) and vice versa.

Conclusions:

Current national efforts at addressing the AIDS pandemic can only be successful when the issue of AIDS is de-stigmatized and is made a critical part of those efforts. One way to do this is through well-designed messages that should be posted in the media, community halls, health centers and other public places aimed at humanizing the disease and those affected and infected by it. […]

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Background:

Mammography has been used in developed countries with considerable success but very little is known about this imaging modality in low resource settings. This study examined the level of awareness of mammography and determined factors influencing the level of awareness. Methods: We conducted a hospital based cross sectional study to investigate the level of awareness of mammography among 818 randomly selected women attending the General Outpatient clinics (GOP) of the University College Hospital (UCH), Ibadan, Nigeria. Independent predictors of level of awareness of mammography were identified using multiple logistic regression analysis. Results: The proportion of women who ever heard of mammography was 5%, and they demonstrated poor knowledge of the procedure. Those with primary or secondary levels of education were about three times less likely to be aware of mammography when compared with those with tertiary level of education (OR = 0.3, 95% CI, 0.12 – 0.73). Also, participation in community breast cancer prevention activities (OR = 3.4, 95% CI, 1.39 – 8.36), and previous clinical breast examination (OR = 2.34, 95% CI, 1.10 – 4.96) independently predicted mammography awareness. Newspapers and magazines appeared to be the most important sources of information about
mammography screening. […]

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Failure of the plenitude of interventions in non-specific mechanical low-back pain (LBP) management is implicated on its heterogeneity. Identifying specific syndromes and subgroups of patients with mechanical LBP has been recognized as a recent development in LBP research. This study aimed to assess the pattern of McKenzie syndromes (MS) and directional preference (DP) of patients who were referred for physical therapy treatment of mechanical LBP. […]

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Achieving Millennium Development Goal 4 is dependent on significantly reducing neonatal mortality. Low birth weight is an underlying factor in most neonatal deaths. In developing countries the missed opportunity for providing life saving care is mainly a result of failure to identify low birth weight newborns. This study aimed at identifying a reliable anthropometric measurement for screening low birth weight and determining an operational cut-off point in the Uganda setting. This simple measurement is required because of lack of weighing scales in the community, and sometimes in the health facilities. […]

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Although, Nigeria had conducted various national surveys followed by central and state level trainings for survey administrators, prior pre-survey trainings have not been systematically evaluated to assess their impact on knowledge gain and final outcome of the survey. A central training of trainers’ session was organized for master trainers on the conduct of the 2012 National AIDS and Reproductive Health Survey.To evaluate the impact of training on the quality of conduct of a national research survey in the 36 states and the Federal Capital Territory in Nigeria. […]

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Our aim was to estimate the prevalence of abnormal glucose regulation (AGR) (i.e. diabetes and pre-diabetes) and its associated factors among people aged 35-60 years so as to clarify the relevance of targeted screening in rural Africa.

A population-based survey of 1,497 people (786 women and 711 men) aged 35-60 years was conducted in a predominantly rural Demographic Surveillance Site in eastern Uganda. Participants responded to a lifestyle questionnaire, following which their Body Mass Index (BMI) and Blood Pressure (BP) were measured. Fasting plasma glucose (FPG) was measured from capillary blood using On-Call® Plus (Acon) rapid glucose meters, following overnight fasting. AGR was defined as FPG ≥6.1mmol L-1 (World Health Organization (WHO) criteria or ≥5.6mmol L-1 (American Diabetes Association (ADA) criteria. Diabetes was defined as FPG >6.9mmol L-1, or being on diabetes treatment. […]

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The knowledge on emergency obstetric care (EmOC) is limited in Kenya, where only partial data from sub-national studies exist. The EmOC process indicators have also not been integrated into routine health management information system to monitor progress in safe motherhood interventions both at national and lower levels of the health system. In a country with a high maternal mortality burden, the implication is that decision makers are unaware of the extent of need for life-saving care and, therefore, where to intervene. The objective of the study was to assess the actual existence and functionality of EmOC services at district level. […]

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Gender based violence is key among other factors in fanning the spread of the HIV/AIDS pandemic. Focusing on inequitable power relations, the lack of power to negotiate with the male partners, low economic status and inaccessibility to health care information puts women and girls at a much higher risk of contracting HIV/AIDS. This paper looks at the ways in which violence is dramatized based on the existing (mis)conceptions and misunderstandings of gender roles and sexuality within the H television program Siri. We argue that the persisting spread of HIV/AIDS could be partly blamed on the damaging expectations from the society and the gender and sexuality stereotypes that put both men an of contracting and further transmitting HIV/AIDS. The media has however been on the forefront in providing vital health care information on reproductive health, particularly on HIV/AIDS as well as providing forums which people can dialogue on a range of issues related to HIV/AIDS. […]

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More than 70% of children with sickle cell disease (SCD) are born in sub-Saharan Africa where the prevalence at birth of this disease reaches 2% or higher in some selected areas. There is a dearth of knowledge on comprehensive care received by children with SCD in sub-Saharan Africa and its associated cost. Such knowledge is important for setting prevention and treatment priorities at national and international levels. This study focuses on routine care for children with SCD in an outpatient clinic of the Kilifi District Hospital, located in a rural area on the coast of Kenya. Objective: To estimate the per-patient costs for routine SCD outpatient care at a rural Kenyan hospital. Methods: We collected routine administrative and primary cost data from the SCD outpatient clinic and supporting departments at Kilifi District Hospital, Kenya. Costs were estimated by evaluating inputs – equipment, medication, supplies, building use, utility, and personnel – to reflect the cost of offering this service within an existing healthcare facility. Annual economic costs were similarly calculated based on input costs, prorated lifetime of equipment and appropriate discount rate. Sensitivity analyses evaluated these costs under different pay scales and different discount rate. […]

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The prevalence of unintended pregnancy in Kenya continues to be high. The 2003 Kenya Demographic and Health Survey (KDHS) showed that nearly 50% of unmarried women aged 15–19 and 45% of the married women reported their current pregnancies as mistimed or unwanted. The 2008–09 KDHS showed that 43% of married women in Kenya reported their current pregnancies were unintended. Unintended pregnancy is one of the most critical factors contributing to schoolgirl drop out in Kenya. Up to 13,000 Kenyan girls drop out of school every year as a result of unintended pregnancy. Unsafe pregnancy termination contributes immensely to maternal mortality which currently estimated at 488 deaths per 100 000 live births. In Kenya, the determinants of prevalence and determinants of unintended pregnancy among women in diverse social and economic situations, particularly in urban areas, are poorly understood due to lack of data. This paper addresses the prevalence and the determinants of unintended pregnancy among women in slum and non-slum settlements of Nairobi. […]

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In most countries, people who have a low socioeconomic status and those who live in poor or marginalised communities have a higher risk of dying from non-communicable diseases (NCDs) than do more advantaged groups and communities. Smoking rates, blood pressure, and several other NCD risk factors are often higher in groups with low socioeconomic status than in those with high socioeconomic status; the social gradient also depends on the country’s stage of economic development, cultural factors, and social and health policies. Social inequalities in risk factors account for more than half of inequalities in major NCDs, especially for cardiovascular diseases and lung cancer. People in low-income countries and those with low socioeconomic status also have worse access to health care for timely diagnosis and treatment of NCDs than do those in high-income countries or those with higher socioeconomic status. Reduction of NCDs in disadvantaged groups is necessary to achieve substantial decreases in the total NCD burden, making them mutually reinforcing priorities. […]

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There is a need to better understand the various social, psychosocial and behavioral factors associatedwith sexual activity among young adolescents in various settings in Sub-Saharan Africa.Data were drawn from Wave 1 (2007–2008) and Wave 2 (2009) of the Transition to Adulthood study,which collected information about key markers of the transition to adulthood and social, demographic and psychosocial characteristics of male and female youth living in two informal settlements in Nairobi, Kenya. Logistic regression analyses were used to examine variables associated with experience of sexual debut by Wave 2 among youth who were aged 12–16 and sexually inexperienced at Wave 1.Of the 1,754 youth in the sample, 92 experienced sexual debut between survey waves. For both males and females, sexual debut was positively associated with having permanently dropped out of school (odds ratios, 6.9 and 21.8, respectively), having never attended school (8.6 and 39.4) and having experienced severe family dysfunction (2.8 and 5.7). Lack of parental supervision was a predictor of sexual debut among males only (10.1), whereas low aspiration was a predictor among females only (10.4). Surprisingly, young women, as well as men, who did not have high self-esteem were less likely than those who did to initiate first sex between waves (0.4 and 0.3). […]

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This paper estimates the effects of human capital skills largely created through education on life’s chances over the life cycle. Qualifications as a measure of these skills affect earnings, and schooling affects private and social non-market benefits beyond earnings. Private non-market benefits include own-health, child health, spousal health, infant mortality, longevity, fertility, household efficiency, asset management, and happiness. Social benefits include democratization, civil rights, political stability, reduced crime, lower prison, health and welfare costs, and new ideas. Individual benefits enhance community-wide development. […]

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This article investigates the correlates of the timing of transition into motherhood among adolescent girls in two informal settlements or slums – Korogocho and Viwandani – in Nairobi city, Kenya. Entry into motherhood is an important marker of the transition to adulthood. Other markers include leaving school, entering the labour force, leaving one’s natal home and getting married. However, adolescent fertility has been viewed as both a social and policy challenge in many countries in sub-Saharan Africa (World Health Organization, 2011; United Nations Children’s Fund, 2012a; National Research Council & Institute of Medicine, 2005). To effectively address this challenge, there is a need to understand the factors driving adolescent childbearing, especially in resource-poor settings such as informal settlements. […]

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The study purpose was to determine the association between sexual debut and HIV sero-status, and factors contributing to a positive HIV sero-status. Retrospective cross-sectional data from the Kenya Demographic and Health Survey-2003 were used. Data on women aged 15-49 (n=3,273) and men aged 15-54 (n=2,917) accepting HIV testing were retained from three datasets. Stata version 10.1 was used for analyses, p<0.05. Nine percent of women and 5% of men tested positive for HIV, of whom 46% and 49%, p<0.001 were aged 16-21 respectively. After adjusting for confounding, women and men who had sexual debut aged 16-21 were 2.31 (95% CI: 1.52-3.51), p<0.001 and 1.83 (95% CI: 1.07-3.13), p<0.05 times more likely to test positive for HIV compared to those who never had sex respectively. [...]

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