Sexual assault in Ile-Ife,Nigeria

Background:

Sexual assault (SA) is a shattering malevolence against women. This study determined the burden, periodicity, presentation and management of SA in Ile-Ife, Nigeria.

Materials and Methods:

Retrospective analysis of the hospital records of 76 SA survivors managed over a 5-year period (2007-2011) in Obafemi Awolowo University Teaching Hospitals complex (OAUTHC), Ile-Ife.

Results:

Sexual assault accounted for 0.69% of all female and 5.2% of all gynaecological emergencies in OAUTHC, Ile-Ife. The survivors’ ages ranged from 4 to 50 years (mean = 17.7 ± 8.8years) and adolescents made up for 48%. The peak prevalence of SA was in February and December and among adults and under-16-year-old survivors, respectively. Daytime and weekday SA were significantly more common among the under-16-year-old survivors (P = 0.008). Majority of the survivors (62%) knew their assailant(s). Neighbours were the commonest perpetrators identified (28.2%) and the assailants’ house was the commonest location (39.4%). Weapons were involved in 29.6% of cases and various injuries were identified in 28.2% of the survivors. Hospital presentation was within 24 hours in majority (76.1%) of the survivors, but rape kit examinations were not performed as the kits were not available. Although appropriate medical management was routinely commenced, only 12.7% of survivors returned for follow-up.

Conclusions:

Seasonal and diurnal patterns exist in the prevalence of SA in Ile-Ife and most survivors that reported in the hospital presented early. Rape kit examinations were, however, not executed, due to non-availability. Personnel training, protocol development, provision of rape kits and free treatment of SA survivors are, therefore, recommended. Public enlightenment on preventive strategies based on the observed periodicity and age patterns is also suggested.     

Teenagers'' Sexual Behavior in Sweden, Europe

Objective To investigate the development of sexuality from early to late adolescence,and to compare girls and boys of different agesMethods A cross sectional survey in all schools was performed covering all pupilsbetween 13 and 18years of age that were in school when the survey was conducted. Avalidated instrument, Q90, created for use in teenagers was distributed in the class-rooms to 3 216 teenagers. Q90 covers 30 questions about body development andsexual behavior. Non-response was insignificant (n=19; 0. 6%).Results Pubertal development was considered "early" or "late" by about 50% ofboth boys and girls. Eighty percent of the 13 to 15 years old boys and girls had had aromance and 30% had experience of sexual cuddling (petting), while significantlymore girls than boys had sexual intercourse (18% vs 13%; odds ratio 1.5, 95% CI1.1-1.9). The difference between girls and boys remained in those being 16-18 yearsold, where 63% of the girls and 53% of the boys (odds ratio 1.5, 95% CI 1.2-1.9)admitted having intercourse. Mean age at first intercourse was 14.9 and 15 years,respectively. At 16-18years of age, 23% of the sexually active girls, as compared with25% of the boys estimated that they had had 6 or more sexual partners. About 30% ofthe adolescents, irrespective of age and gender, did not use contraceptives at theirfirst and latest intercourse. Eight percent of the older girls had been pregnant, andthey had an increased history of sexually transmitted infections, as compared withthe boys (6.2% vs 2.7%; odds ratio 2.4, 95% CI 1.2-5.0).Conclusion Exploring sexuality and experimentation is a normal behavior inadolescence. The results of this study, however, indicate that there are substantialgroups of teenagers who practice sexual risk-taking. In addition to general sexualeducation, programs should also be directed to define sexual risks and its consequences.     

Improving Sexual and Contraceptive Behaviours of Unmarried Female Youth with First Trimester Induced Abortion in Sichuan, China

Along with concerns about the spread of HIV/STDs in China comes increasing evidence of risky sexual behaviours among Chinese youth. Proportion engaging in premarital sex have reportedly increased, and is usually unprotected. Unwanted pregnancies, abortion…     

Contraceptive Prevalence and Pattern among HIV Positive Women in Port Harcourt, South-South Nigeria

Objective To evaluate the prevalence rate and pattern of contraceptive use among HIV positive women in Port Harcourt, Nigeria. Methods Anonymous self administered questionnaires were applied to HIV positive women receiving care at HIV clinic of the University of Port Harcourt Teaching Hospital between September and November 2010. Results A total of 228 questionnaires were retrieved out of 250 distributed. The grouping age 29-34 years accounted for 47.8% of the respondents, 51.3% had secondary education, 55.5% were married while 43.4% were nulliparous. The mode of acquiring HIV was unknown in 60.1% and 34.2% of their partners were HIV positive. Majority (64.0%) of the patients did not use any form of contraception before diagnosis while 42.1% used male condoms after diagnosis. Contraceptive methods used were female condom (0.4%), oral contraceptive pills (16.2%), abstinence (14.5%) and rhythm method (1.8%). Only 6.1% used the dual method, which is the simultaneous use of two methods and one of which must be a condom. Contraceptive prevalence rate (CPR) was 81.1%. Conclusion Though the overall use of contraception in HIV positive women in Port Harcourt is high, the dual method use which protects against pregnancy and transmission of HIV is low. Dual method is the recommended method for HIV positive women who do not intend to get pregnant. Therefore the use of dual method should be advocated.     

Study on Vaginitis Among Intrauterine Contraceptive Device Users in Ibadan, South-western Nigeria

Objective To investigate IUD-related vaginitis in IUD users at the University College Hospital Ibadan, South-western Nigeria.
Methods A prospective cohort study in IUD users present with abnormal vaginal discharge at the family planning clinic of the University College Hospital, Ibadan was conducted between lOth of October, 2008 and 31st of May 2009. High Vaginal Swabs were taken from the clients for microbiology, culture and drug sensitivity test. Diagnosis of bacterial vaginosis was made based on gram stained vaginal smear using the standard Nugents criteria. Other aetiological agents were identified either on wet preparation or culture using standard techniques. Treatment given was by the family planning nurse, as was the protocol at the family planning clinic.
Results Twenty-four IUD users present at the Jamtty ptannmg ctmtc with vaginal discharge were studied. Their ages ranged 28-51 years（38.14 ± 5.9 years）, Mean parity was 4.4 ± 1.4, All the women were married and all used CuT 380A. The mean duration of lUCD use was 2.5 years only. Majority （46%） had used it for more than 3 years and most （75%） of the visits were unscheduled. All the clients complained of abnormal vaginal discharge which was copious, watery and foul smelling, or clumpy. Nine users （37.5%） complained of pruritus vulvae, 3 users （12.5%） lower abdominal pain, 1 user （4,2%） dyspareunia and vaginosis was made in 16 （66. 7%） and 1 （4.2%） dysuria. The diagnosis of bacterial vaginal candidiasis in 8 （33.3%）. Age less than 40 years, Christianity and IUD use more than 3 years were associated with a higher risk of bacterial vaginosis （OR=1.29, 1.67 and 6.6, respectively）, while women above 40 years, Muslims and women with lower educational status had a higher risk of candida-related vaginitis （OR=1.67 and 4.2, respectively）. Eight clients （33.3%） were treated for candidiasis with antifungals （3 empirically, and 5 after obtaining results of vaginal swab）, 9 （37.5%） were given oral metronidazole, 3 patients were referred to the gynaecological emergency unit on account of abdominal pain and 4 did not return for follow up.
Conclusion IUD associated vaginitis is a disturbing condition causing unscheduled visits among IUD users. Bacterial vaginosis and Candidia albicans are major aetiologies in south western Nigeria Ibadan. Persistent discharge is a documented reason for discontinuation of lUD use. Periodic empirical treatment for candidiasis and bacterial vaginosis with antifungals and oral metronidazole is advocated. This may reduce the discomfort caused by IUD-related vaginitis, the risk of PID and other risks exposed to the IUD users and ensure continued use of the IUD.     

Sexual Behaviour of Rural College Youth in Maharashtra, India： An Intervention Study

Objective To promote healthy sexual behaviour among rural college youth.
Methods The intervention study consisted a sample of 1 500 （800 male and 700female） in baseline and 1 953 （1 022 male and 931 female） college going students in post intervention, in the age groups 15-24 years from 8 colleges in Thane district of Maharashtra. The interventions included dissemination of lEC （Information, Education and Communication）, counselling in colleges and provision of health care services at rural health centers in the experimental area. Male and female teachers and peer leaders were trained to provide IEC. Chi-square test was carried out to find out the association between contributing factors and sexual behaviour.
Results Post intervention results showed that overall any sexual experience （coital/ non-coital） increased by 2.6% and 1.0% among male students and 4.6% and 0.8% among female students in control and experimental groups respectively which suggests that in the control area physical closeness and sexual relationship has increased between sexes. A significant improvement was noted in the usage of condom during their sexual intercourse in experimental group. The provision of IEC in college settings, peer leader training and orientation to teachers helped students and teachers to initiate a dialogue on reproductive health issues. Intervention programs helped college youth to develop the skills, make informed decisions about engaging in sexual intercourse and using contraceptives in a social context that sometimes encourages risky sexual behaviour. The study found that peer interaction was exposure to erotic material; habits and working status among boys and peer interaction and place of study among girls were closely associated with their coital and non-coital sex experience.
Conclusion A scientifically developed, need based and demand driven reproductive health service package for male and female students in colleges can help them to develop their knowledge, skills and attitudes for critical     

Relationship between Contraceptive Knowledge, Cognition and Behaviors among Vocational High School Students

Rise in prevalence rate of sexual activity among middle/high school students have gone with decline in age of sex initiation in recent years. Due to special training purposes and characteristics of student resources, most vocational high school students s…     

Combined Oral Contraceptive Pills: Profile of Acceptors in a Tertiary Hospital in South-South Nigeria

BACKGROUND: Combined oral contraceptive pills were the first contraceptive method to provide sexual freedom of choice for women through reliable, personal and private control of fertility. They are the most widely used hormonal contraceptives and also the most popular non-surgical method of contraception. OBJECTIVE: To review the profile of acceptors of combined oral contraceptive pills at the University of Uyo Teaching Hospital, Uyo. METHODOLOGY: An 8 year review of all clients that accepted combined oral contraceptive pills in the family planning clinic. RESULTS: There were 1,146 new contraceptive acceptors during the period of study out of which 309 (27.9%) accepted the pills. Majority of the clients were between 20 and 29 years of age (54.0%), were multiparous (72.8%), Christians (99.7%) and 61.2% had tertiary level education. Two hundred and fifty-five women (82.5%) desired to use combined oral contraceptive pills to space births while 7.8% wanted to limit child bearing. There was a high discontinuation rate among the women (45.0%) and out of these 87.9% of the clients changed to other contraceptive methods. All the clients commenced their pills within seven days of menstruation and only the low dose monophasic preparations were available in the family planning unit and thus were given to the clients. CONCLUSION: Women who accept to initiate combined oral contraceptive pills in our center are young, well educated, multiparous women who want to space their pregnancies. However, due to the high discontinuation rate among the clients, there is need for further studies evaluating reasons for the high discontinuation rate, exploring interactions between clients and providers' and also providers' attitude towards combined pills in our environment.     

Characteristics of Contraceptive Use in Sao Paulo State, Brazil

Objective To know the characteristics of contraceptive use in Sao Paulo State collected by the Demographic and Health Survey （DHS） conducted in 1996. Methods Data of Sao Paulo in 1996 were analyzed compared with the previous DHS carried on in 1986focusing on Sao Paulo State. Contraceptive use among married or cohabiting women by age, number of children and schooling was closely examined. Age and timing of female sterilization were also analyzed. Results The results showed that unlike Brazil there was a stability of female sterilization in Sao Paulo State during 1986 and 1996. There was a pattern in Sao Paulo： up to 30 years old the pill was the most used contraceptive, after 30 there was a predominance of female sterilization, which increased with the number of children and decreased with schooling. The use of male methods had also increased in the 1986 and 1996 period, being greater in Sao Paulo than in Brazil. Sao Paulo also presented more diversity in the use of reversible contraceptives. Conclusions The predominant two contraceptive methods in Brazil and Sao Paulo changed from 1986 to 1996, i.e..from pill to female sterilization.     

Pattern of intrathoracic goiter in Ibadan,Nigeria

This study is to review the pattern of intrathoracic goiter in a large black population. In a retrospective review, the cardiothoracic unit managed ninety-eight primary mediastinal masses of which sixteen patients with intrathoracic goiters were treated during the same period. This constitutes 1.3% of treated goiters and 16.3% of primary mediastinal masses. Seventy-five per cent of the intrathoracic goiters were in association with cervical goiters. Twelve of the intrathoratic goiters were located in the anterosuperior mediastinum, and two in the middle mediastinum. There were three goiters in the posterior mediastinum. Six patients had cervical exploration and median sternotomy, three had cervical exploration and thoractomy, 3 had only thoractomy, two had only median sternotomy for excision. Thirteen patients (81.3%) had either simple colloid or multinodular intrathoracic goiter, one had follicular adenoma, and 2 patients had malignant goiters. One patient had recurrent cervical goiter. The endemicity of thyroid disease does not seem to increase the frequency of intrathoracic goiter.     

重庆地区大学生性健康教育状况现状调查分析

目的 了解大学生性健康教育现状,为进一步开展大学生性健康教育提供依据.方法 使用自行设计问卷对重庆市某综合大学不同院系共780名学生进行问卷调查.结果 59%学生没有上过性教育课;90%以上学生觉得自己对性知识了解程度不足;性知识主要来源于互联网和报刊杂志;80%以上学生认为课堂讲授、观看录像是最好的获得性健康知识的形式,98%学生认为有必要开展性心理生理咨询.结论 大学生对性知识了解程度较低,学校提供性健康教育严重不足.因此采取适当形式开展系统的学校性健康教育是十分必要的.     

Association of Soft Drink Consumption,Eating Behaviour and Dietary Factors on Body Composition among South Indian Adolescents

Intake of soft drinks is linked to non-communicable diseases. The study aims to examine the association of soft drink consumption, eating behaviour and dietary factors on body composition of college students. Consumption of soft drinks may be a key contributor to the epidemic of overweight and obesity, by virtue of these beverages＇ high added sugar content, low satiety, and incomplete compensation for total energy. Five hundred subjects （250 boys and 250 girls） aged 17 - 23 years studying in colleges in Chennai, India were selected. Data pertaining to demographic profile, soft drink consumption pattern and dietary habits were elicited using a questionnaire. Anthropometric measurements and nutrient intake was assessed in a sub sample of 100 subjects. Results indicate that higher percent of female consumers （60%） prefer non-caffeinated soft drinks, while male consumers （54%） prefer eaffeinated soft drinks. About 10 percent of consumers compensate meals with soft drinks. A significant association was found between soft drink consumption and appetite （P〈0.01）. Soft drink consumers had a significantly higher intake of macronutrients, while non-consumers had a higher intake of calcium and vitamin A （P〈0.0 1）. Consumers had significantly higher anthropometric measurements and indices compared to non-consumers （P〈0.01 ）. Preferences to soft drinks, accessibility, peer pressure, unhealthy dietary practices significantly increased soft drink consumption, macronutrient intake and reduced micronutrient intake leading to higher mean weight, BMI, waist circumference and percent body fat. Healthy dietary and life style practices should be encouraged among adolescents to alleviate the risk of non-communicable diseases.     

Impact of Life Skills Training to Improve Cognition on Risk of Sexual Behavior and Contraceptive Use among Vocational School Students in Shanghai,China

Objective To evaluate the impact of life skills training that uses participatory teaching method on improving reproductive health cognition of vocational school students of metropolitan, China.
Methods Three vocational schools of an urban district in Shanghai were selected as the research sites, with two schools as the intervention groups（group A and group B） and the other as the control（group C）. Group A was provided life skills training with core of reproductive health plus peer education, while group B only provided life skills training. All the second grade students were recruited as the subjects. Baseline surveys were conducted in three schools before the implementation of the intervention, and similar surveys were conducted after two terms of the intervention to test the effectiveness of the intervention. In total, 1 612 subjects, including 810 males and 802 females, were recruited. The effects of the intervention on subjects＇ cognitions on sexual behavior and condom/contraceptive use were analyzed using mixed model with repeated measures.
Results From pretest to posttest, there were significant increase of the proportions of perceiving risks in getting pregnant, infecting STDs and HIV, benefits by learning and using condom, and self-efficacy in contraceptive use, and decrease of the proportions of perceiving barriers for condom use in two intervention groups; while few similar changes in the control group. In mixed modeling analysis, interaction effects of group A × time and group B × time were found on the scores of perceived risks （P〈0.000 1）, perceived benefits （P〈0.000 1）, perceived barriers （P=0.001 2for group A and P=0.003 4 for group B）,and perceived self-efficacy （P〈0.000 1）. The significant difference of the effects between two interventions was only observed on perceived benefits （P 〈0.000 1）.
Conclusion Life skills training using participatory approaches is effective in improving students＇ reproductive health cognition and could be used as an importan     

Histopathological profile of childhood thyroid carcinoma in Ibadan,Southwestern Nigeria

BackgroundThyroid carcinoma is a common endocrine malignancy. It is however rare in childhood and often occurs as a result of radiation exposure or inherited genetic mutations. Most childhood thyroid carcinomas are well differentiated. There are very few epidemiological studies of this disease in Nigeria and our study aimed to determine the frequency in a subset of our population. The study aimed to determine the prevalence and histopathological characteristics of childhood thyroid carcinoma in our environment.MethodsThis was a retrospective review of histopathologically diagnosed thyroid carcinoma in children less than 18 years of age in the Department of Pathology, University College Hospital, Ibadan over a 40-year period. Histopathological diagnosis, age, sex and other relevant clinical information were extracted from the hospital records and surgical pathology records of the department. All cases of patients under18 years old had their slides re-examined and reclassified by two pathologists according to the World Health Organization histopathological classification of thyroid tumours.ResultsThere were 25 cases of thyroid carcinomas seen in children within the study period. Papillary thyroid carcinoma was the most common, accounting for 80% of the cases. Follicular carcinoma accounted for 12%, and medullary and anaplastic carcinoma accounted for 4% each. The mean age at presentation was 13 years. There was a female preponderance with females accounting for 60% of cases. Tumours with distant metastasis made up 20% of the cases.ConclusionChildhood thyroid carcinomas are rare in our environment, with a minority of cases presenting with metastases.