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ORIGINAL ARTICLES
Pattern of traumatic tympanic membrane perforations in Benin city
Ufuoma Maris Efole, Amina Lami Okhakhu
June 2021, 6(1):1-5
DOI:10.4103/jmwa.jmwa_1_21  
BACKGROUND: Trauma is a recognised aetiological factor in tympanic membrane (TM) perforation. TM perforation remains a common presentation and is often with deleterious sequelae. AIM: The aim of this study is to determine the aetiological factors responsible for TM perforation as well as traumatic TM perforation (TTMP) among patients seen in the University of Benin Teaching Hospital (UBTH), Benin City. METHODS: A 2-year retrospective review of first time attendees with otologic symptoms at the ENT, H and NS Department of UBTH from January 2017 to December 2018. Data retrieved included age, sex, presenting complaints, aetiologic factors, examination findings, treatment and outcome. Data were analysed using the SPSS® software version 22. RESULTS: A total of 240 patients with TM perforations were seen. There were 107 (44.6%) males and 133 (55.4%) females giving a male:female ratio of 1:1.2. The age range was 2–85 years with a mean age of 32.63 (standard deviation ± 20.99) years. The aetiology for TM perforation was infective in 198 (82.5%) while traumatic in 42 (17.5%). Among the cases of traumatic perforations occurring in 42 patients (24 males and 18 females), assault from unknown assailant was the most common cause 13 (22.2%) occurring mostly in males. Domestic assault was the most common cause of TTMP in females, accounting for 10 (14.8%) of the 11 cases (18.5%) while self/parent inflicted was the most common cause in children. CONCLUSION: The spate of violence in the society is on the increase and the presence of TTMP may be an indicator. Males usually present due to assault from strangers/security agents. Domestic violence is almost exclusively responsible for TTMP in females.
  1,776 149 -
Is there a gender disparity in the residency training programme? Perspectives of trainees from a tertiary hospital in Nigeria
Omumuawuike Chinenyenwa Ebi, Akpabio Akanimo Akpabio, Edesiri Ejovwoke Ighorodje, Mkpang Esio Emenyi, Enobong Cyril Mkpang, Christie Divine Akwaowo
June 2021, 6(1):6-11
DOI:10.4103/jmwa.jmwa_2_21  
INTRODUCTION: Universal health coverage in Africa is constantly threatened by inadequate workforce relative to the health needs of the population. These inadequacies may be worsened by gender disparities with female doctors worse affected. This study aims to highlight the gender distribution of residents across specialties, compare the residency programme experiences of male and female trainees and assess their perspectives towards gender disparities in training. METHODOLOGY: This was a pretested cross-sectional online survey using Google Forms© involving all 208 University of Uyo Teaching Hospital (UUTH) residents with additional information from the hospital database. Data was analyzed using Stata version 16 with statistical significance P < 0.05. Ethical approval was obtained for the study. RESULTS: Of 208 trainees, 128 (61.5%) were male while 80 (38.5%) were female. Departments had from 2 (ENT) to 29 residents (internal medicine). A response rate of 58.6% was obtained from 122 respondents (62.3% males). General surgery had a 100% male predominance while paediatrics had a 68% female predominance. Most respondents (72.9%) felt that the programme was quite stressful and 36.9% had considered leaving. Half of the trainees (50.8%) got maximum support from their families in the form of emotional and psychological care. While 73.8% acknowledged gender disparities, only 24.6% experienced discrimination. CONCLUSION: The UUTH residency training programme is male dominated, especially in general surgery with training challenges experienced by male and female trainees. Gender disparities exist though only a quarter experienced discrimination. Existing disparities should be urgently addressed and gender mainstreaming promoted by training institutions.
  1,774 134 -
A 10-year retrospective study on a population-based cervical cancer screening programme in Nigeria
Christie Divine Akwaowo, Uwemedimbuk Smart Ekanem, Enobong Cyril Mkpang, Catherine Sebastian Eyo, Emem A Abraham, Mabel Ino-Ekanem, Uduak Ime Usanga, Ubong Mbatt Ekaete, Ako Akpabio, Mfon Edyang-Ekpa, Medical Women's Association of Nigeria, Akwa Ibom State
June 2021, 6(1):21-30
DOI:10.4103/jmwa.jmwa_5_21  
BACKGROUND: Human papillomavirus (HPV) is the main cause of cervical cancer, and about 80% of women will be infected at least once in their life time. Cervical cancer is the fourth most common cancer in women and the second highest cause of cancer deaths. Persistent HPV infection progresses to cancer over several years, and during this period, pre-cancerous lesions can be detected by screening. Visual inspection under acetic acid (VIA) is an easy safe, affordable and effective test in cervical cancer screening in resource-poor countries like Nigeria. AIM: The aim of the study is to determine the proportion of women with VIA-positive findings and the associated factors among those screened for cervical cancer in a screening programme between 2008 and 2017. METHODS: This is a retrospective study using the database of women who presented for breast and cervical cancer screening by the Akwa-Ibom State branch of the Medical Women's Association of Nigeria between 2008 and 2017. A structured questionnaire was used to abstract data from the records of the attendees at the cancer screening sessions in the years indicated. There are many factors that discourage women from screening for cervical cancer. Some authors cite embarrassment, low perception of cancer risk, physician gender preference, lack of spousal support; high cost; belief that cancer is a death sentence, and societal discrimination. RESULTS: A total of 2203 women were screened for cervical cancer between 2008 and 2017. The mean age was 40.2 years. Only 284 (12.9%) women had been previously screened for cervical cancer, and majority of these were screened over 2 years prior. The mean age at sexual debut was 19.4 years, those who had used contraceptive pills in the past were 639 (29.0%) while 124 (5.6%) used it currently. Forty-four (2.0%) of the screened women had VIA-positive lesions, and 1.6% had lesions suspicious for cancer. On bivariate analysis, age, marital status, age at sexual debut, number of pregnancies and previous use of oral contraceptive pills were significantly associated with findings on VIA. CONCLUSION: This study found VIA-positive findings in a small proportion of the women screened. A follow-up of the definitive diagnosis and treatment of the VIA-positive women is strongly recommended. Efforts should be made to provide early comprehensive sex education and screening to detect early lesions to reduce morbidity and mortality from cervical cancer in the population.
  1,781 123 -
Assessment of visual acuity amongst school-aged students in Southern Cross River State, Nigeria
Nnette Okon Ekpenyong, Doris Nwoha
June 2021, 6(1):12-16
DOI:10.4103/jmwa.jmwa_3_21  
BACKGROUND: Visual impairment is a major public health concern worldwide, with uncorrected refractive errors as a major cause of visual impairment in children. Most of the causes of this visual impairments can be prevented or easily corrected. AIM AND OBJECTIVES: This study seeks to determine the prevalence of visual impairment and factors responsible for visual acuity screening amongst school-aged children in Southern Cross River State, Nigeria. METHODOLOGY: This was a cross-sectional descriptive designed study using a multistage sampling technique, with a self-administered questionnaire to obtain quantitative data from school-aged children in secondary schools in Calabar Municipality, Southern Senatorial District of Cross River State in South-South Nigeria. RESULTS: The mean age of respondents was 13.9 ± 2 years. The prevalence of visual impairment amongst students was 5.7%. Although majority of the respondents (73.9%) were aware of visual acuity screening test, only 33.9% of the respondents had ever had a visual acuity test done. A statistically significant association was found (P < 0.05) between those students who were aware of eye screening test, had their vision deteriorate or have their academic performance affected by their vision and the practice of performing an eye screening test. CONCLUSION: Awareness of visual acuity screening did not translate into practice, so it is necessary for visual acuity screening test to be made mandatory for all school-aged children to help detect visual impairment early.
  1,539 134 -
Cardiac troponin I level in healthy newborn babies in Ilorin, North-Central Nigeria
Amudalat Issa, Mohammed Baba Abdulkadir, Olayinka R Ibrahim, Habibat Suberu, Ruqayat Ronke Bakare, Ibraheem Sanusi, Omotayo Olukemi Adesiyun
June 2021, 6(1):17-20
DOI:10.4103/jmwa.jmwa_4_21  
BACKGROUND: Cardiac troponins are reliable markers for the diagnosis of myocardial ischaemia. Cardiac troponin I is a valuable biomarker that has gained popularity across all ages including newborns. However, its usage in our environment in the paediatrics age group is limited probably because few studies have evaluated the normal levels in the healthy children. Hence, we determined the cardiac troponin I level in healthy term newborns. METHODOLOGY: This was a cross-sectional analytical study that involved 85 healthy term appropriate for gestational age newborns aged 24–72 h of life. The babies had relevant demographic parameters collected in a study pro forma. We determined the cardiac troponin I assay using enzyme-linked immunosorbent assay (Enzyme linked immunosorbent assay method (ELISA)) method. RESULTS: The median (interquartile range [IQR]) cardiac troponin I level was 0.79 (0.79–1.42) ng/ml. The cardiac troponin I level in male newborns, 1.05 (0.79–1.55) ng/ml, was higher but comparable with female newborns, 0.79 (0.79–1.00) ng/ml, P = 0.227. The cardiac troponin I increases with gestational age, P = 0.049. There was no relationship between cardiac troponin I level and birth weight, chronological age and mode of delivery (P > 0.05 in each). CONCLUSION: The study demonstrated cardiac troponin I levels in healthy term Nigerian newborns with a significant relationship with gestational age.
  1,531 95 -
Assessment of birth registration awareness and practice in Du District, Jos South Local Government Area, Plateau State, Nigeria
Chundung Asabe Miner, YO Tagurum, IA Osagie, A Agba, MI Shindang, NA Emeribe, FD Kumbak, PA Udoh, TF Hosle, NG Bulus, AF Odoh
June 2021, 6(1):31-38
DOI:10.4103/jmwa.jmwa_6_21  
BACKGROUND: Birth registration is a fundamental human right, often overlooked due to a lack of awareness of its importance. Birth registration data, when correctly collected, can play important roles in a country's economic and social development in the areas of planning, implementation, monitoring and evaluation of policies to inform resource allocation. The study assessed the awareness and status of birth registration in two communities of Du district in Jos South local government area of Plateau State, Nigeria. METHODOLOGY: It was a cross-sectional study that used a mixed method to obtain data. A total of 213 caregivers selected by multistage sampling technique were assessed using interviewer-administered questionnaires and focus group discussions (FGD) amongst four groups of community members. Data were analysed with Epi Info 7 at a P ≤ 0.05. RESULTS: The mean age of the respondents was 32.2 ± 9.5 years. Most (80%) were females and most (88%) were married. Majority (67%) were aware of birth registration. The index child for 93% of the caregivers was given birth to in a hospital and 59% of these children had been registered. The age, marital status of the caregiver, and birth order of the index child were found to be significantly associated with the registration status of the child. FGDs revealed that the communities were aware of the places where birth registration could be done, and that the decision to register was influenced mostly by fathers. CONCLUSION: There is a need for more targeted enlightenment campaigns and community engagement to improve compliance for registration of births.
  1,521 98 -
Assessment of sexual behaviour and utilization of sexual and reproductive health services among secondary school students in ekiadolor, Edo State
Olugbenga Gani Owoeye, Chinyere J Nwaogwugwu
December 2021, 6(2):105-111
DOI:10.4103/jmwa.jmwa_20_21  
BACKGROUND: Sexual and reproductive health (SRH) is an important aspect of health and a fundamental human right which includes sexuality education, family planning, safe motherhood, post-abortion care, prevention and management of sexually transmitted infections and HIV/AIDS. The aim of this study was to assess the sexual behaviour and utilisation of SRH services (SRHSs) among in-school adolescents in Ekiadolor, Edo state. MATERIALS AND METHODS: This was a cross-sectional study conducted among in-school adolescents in Ekiadolor. The respondents were then selected using a multistage sampling technique. An interviewer administered questionnaire was used to obtain data for the study. Data were coded and entered into IBM SPSS version 22.0 for analysis and P < 0.05 was considered significant. RESULTS: A higher proportion of the respondents were male and 58.2% were of early adolescent age group (10–14 years), with a mean age of 14.29 ± 1.72 years. Only 6 (5%) of the respondents had good knowledge. Forty-seven (11.7%) respondents were sexually active and 36 (76.6%) of these engaged in safe sexual behaviour. Seven (1.7%) respondents visited hospital for SRHS and the major services utilised were counselling, HIV testing and acquisition of contraceptive pill. Eighteen (38.3%) of those sexually active had utilised condom during sex. CONCLUSION: There was a poor knowledge of contraception and low level of utilisation of SRHSs among the secondary school students. However, a higher proportion of the sexually active respondents engaged in safe sexual behaviour.
  1,077 122 -
MWAN BIENNIAL CONFERENCE, ASABA 2019 — BOOK OF PROCEEDINGS
Foreword
Minnie Oseji
June 2021, 6(1):39-39
  1,078 61 -
Intimate Partner Domestic Violence in Jos Plateau State Nigeria
Magdalene Irozuru
June 2021, 6(1):80-83
Abstract Background: Intimate Partner Violence (IPV) occurs between two people in an intimate relationship. Common types of IPV are Coercive Controlling Violence (CCV), Violent Resistance (VR), Situational Couple Violence and Mutual Violent Control. Identifying the common types of IPV in a community will go a long way in managing and overcoming it. IPV that involves the death of a member or whole family is on the increase. The cause(s) of IPV are multi- factorial, creating gaps in recognition of IPV. Aim: To identify IPV in Jos. Objectives: To establish relationship between verbal and physical violence; to know the frequency of sexual abuse among respondents; to know respondents' perception on the risk to life as a result of IPV; and to identify health related issues due to IPV. Methodology: Cross-sectional study involving 112 adults, age 21 to 68years. Married women (n=98) unmarried women (n=5) and men (n=12). Self-administered questionnaire for data collection on socio-demographic characteristics and screening tools which include: Hurt, Insult, Threaten, and Scream (HITS) Tool, Woman Abuse Screening Tool (WAST), Partner Violence Screen (PVS) and Abuse Assessment Screen (AAS). Result: Excel version 8 and SPSS version 23.0 were used for data analysis to generate frequencies, percentages, and Chi square associations. Hits: Marital status made signifi cant difference (X2=8.137, p=0.045). WAST: Age, gender and marital status made no signifi cant difference (X2=0.130, p=0.719). PVS: Marital status made signifi cant difference (X2 = 12.690, p=0.005). AAS: Marital status made signifi cant difference (X2=14.447, p=0.002). Discussion: Sexual abuse made no signifi cant difference probably out of denial. Divorce and separation could be due to IPV with high HITS and injuries. Conclusion and Recommendations: IPV occur in Jos. HITS and health related issues from emotional physical abuse by spouse were noted. Institutions should lookout for IPV, its perpetrators and victims, manage appropriately and enforce laws on IPV.
  1,047 71 -
Awareness and Knowledge of Breast and Cervical Cancers Among Women in Delta State
MW A NDELTA, T Obong Dorcas, EN Ali, N Emma-Nzekwue, O Ogelle, UK Okeaba, O Txs Nwakuso
June 2021, 6(1):79-79
ABSTRACT Background: Mortality from breast and cervical cancers has been on the increase in recent times especially in developing countries. Lack of proper awareness and knowledge of cancer symptoms have been shown to be one of the factors responsible for this menace. This study therefore determined the awareness and knowledge of women about cancers, with particular reference to breast and cervical cancers. It also identified the relationship between socio demographic factors (age and education) and level of knowledge and awareness of these cancers. Methodology: A descriptive cross sectional study design was used in this study and a total of 225 women of child bearing age were selected using random sampling from different religious centres in the 3 senatorial districts of Delta State. Data was collected using a questionnaire which was both self and interviewer administered. The questionnaire elicited information on the women's awareness and knowledge of cancers generally with specific emphasis on breast and cervical cancers. Bivariate analysis was done using SPSS version 22. Categorical variables were compared using the Pearson Chi-square test and likelihood ratio where necessary. Significance level was set at 0.05. Results: The study was conducted among 225 women, however, 206 questionnaires was correctly completed with a response rate of 92%. The main sources of information about cancers were television (40.8%) and radio (48.5%). Slightly over one-third (26.7%) of the participants who were aware of breast cancer belonged to age group 30- 39 years and less than two-fifth (38.3%) of participants unaware of cancer were aged 50-59 years. The association between awareness of breast cancer and age group was statistically significant (p = 0.004). The association between knowledge of cervical cancer and age group as well as their level of education was also statistically significant (p<0.05). Conclusion/ Recommendations: The study showed that despite the high level of awareness on the part of the respondents, their level of knowledge about breast and cervical cancers was very low. The study further revealed that a positive relationship existed between the socio demographic factors (age and education) and awareness as well as knowledge of breast cancer, while a positive relationship was observed only between education and knowledge of cervical cancers. Therefore there is the need to use every available opportunity including social media to increase public health awareness on breast and cervical cancers among women.
  1,006 74 -
Women's experience with group prenatal care in a rural community in Northern Nigeria
Sunday E Adaji, Adenike Jimoh, Umma Bawa, Habiba I Ibrahim, Abiola A Olorikuooba, Hamdalla Adelaiye, Comfort Garba, Anita Lukong, Suleiman Idris, Oladipo S Shittu
June 2021, 6(1):84-88
  989 59 -
Advocacy for Gestational Diabetes Mellitus (GDM) Prevention & Care: Lessons Learnt From The Medical Women's Association Of Nigeria (MWAN) Rivers State GDM Project; MWAN-WDF Project for Gestational-Diabetes Program in Niger-Delta (WDF16-1347)
Rosemary Ogu, Omosivie Maduka, Precious Obuah, Vetty Agala, Ufuoma Edewor, Folusho Alamina, Obelebra Adebiyi, Ibimonye Porbeni, Claribel Abam
June 2021, 6(1):76-78
  930 65 -
Acknowledgements
Bobola Agbonle
June 2021, 6(1):40-40
  898 66 -
Key Note Lecture by Dr Eghe Abe, Health Specialist, UNICEF

June 2021, 6(1):41-44
  862 74 -
Factors influencing the acceptance of cervical cancer screening and uptake of human papilloma virus vaccination among female civil servants in Asaba, Delta State

June 2021, 6(1):64-72
  865 68 -
Knowledge, attitude and practice of menstrual hygiene amongst female secondary school students in Kaduna State

June 2021, 6(1):89-90
  861 70 -
Crowdfunding for cancer: Success and challenges of a medical organization in Nigeria

June 2021, 6(1):94-96
  772 148 -
New innovations in cancer treatment, a web search of literature
O Popoola Margaret, B Popoola Olayinka, A Mohammed Bello
June 2021, 6(1):73-75
  852 62 -
ORIGINAL ARTICLES
Breast cancer screening program: Findings from a population-based study in South Nigeria
Christie Divine Akwaowo, Uwemedimbuk Ekanem Smart, Emem Abraham, Catherine Sylvester Eyo, Mandu Ikpe, Nene Andem, Chinonye Otuka, Ukeme Eshiet, Helen Emmah, Christine Essien, Glory Essien, Valerie Okon Obot
December 2021, 6(2):112-120
DOI:10.4103/jmwa.jmwa_14_21  
BACKGROUND : Breast cancer is the most common cancer among women in both developed and developing countries, affecting about 2 million women and causing 6.6% of all cancer deaths each year. Although developed countries have higher rates of breast cancer, the availability of structured screening programmes enables early detection and thus prevention of morbidity and mortality. AIMS : This article presents the findings of a 10-year population-based breast cancer screening programme by a member state of the Medical Women's Association of Nigeria (MWAN). METHODS : A retrospective exploration of the database of MWAN Akwa Ibom state was carried out for 10 years of 2008–2017. RESULTS : A total of 2203 women were screened for breast cancer between 2008 and 2017. Majority were 31–40 years (36.9%) and married (56.8%). Only 27% did monthly self-breast examinations. On clinical breast examination (CBE), breast lump was found in 166 (7.5%) of the respondents, with the most common location being the left outer upper quadrant. An enlarged lymph node was seen in only 1% of the population. Clients aged 20 years or less (24.5%) and those living with a partner (16.1%) formed a significantly higher proportion of those with a breast lump. Respondents who had never breast fed had a significantly higher percentage of breast lumps compared to those who had (10.1%). CONCLUSION : This study found that breast lumps were more common in the younger population and those living with partners. Non-breastfeeding was seen to be associated with an increased risk of developing breast lumps. Routine monthly breast self-examination, regular clinical breast examination and follow-up of individuals with breast lesions are recommended to facilitate early detection of breast cancer in our resource-poor setting. We also recommend reduced age of screening for breast lumps and CBE for younger women.
  814 88 -
MWAN BIENNIAL CONFERENCE, ASABA 2019 — BOOK OF PROCEEDINGS
Strategies for Greater Engagement of MWAN in Global Clinical Trials
Prof Ifeoma Okoye, Ashoka Fellow
June 2021, 6(1):56-59
  822 55 -
Eliminating Harmful Widowhood Practices
Eleanor Ann Nwadinobi
June 2021, 6(1):53-55
  806 66 -
Prevalence and determinants of drug abuse among adolescents in Delta State
Ngozi Ali, Onyi Theresa Nwabuzo, Vivian Wareibi Omo-Aghoja, Ure Okeaba, Olive Ogelle, N Odiakosa
June 2021, 6(1):60-61
  786 62 -
ORIGINAL ARTICLES
Physicians' trust in health systems during the COVID-19 pandemic in Nigeria
Dabota Yvonne Buowari, Nana Awaya Emeribe, Vivian Ifeoma Ogbonna, Evonemo Susan Esievoadje, Chioma Laura Odimegwu, Ogechukwu Mary-Anne Isokariari, Mary Oluwakemisola Agoyi, Omoadoni D Emeagui, Aminat Oluwabukola Jimoh
December 2021, 6(2):129-135
DOI:10.4103/jmwa.jmwa_13_21  
BACKGROUND: Trust in health systems is important in the practice of medicine and medical research. Healthcare workers including physicians need to have trust in healthcare systems during this COVID-19 pandemic. RESEARCH METHODOLOGY: This is a cross-sectional study conducted in Nigeria among physicians practicing in Nigeria. The questionnaire used for this study was adapted from the World Health Organization Blue Print Novel Coronavirus Perceptions of healthcare workers regarding local infection prevention and control procedures for a COVID-19 research protocol. Participants were recruited online. RESULTS: The number of participants in this study was 302, with 195 (64.6%) being females. There was no statistical relationship between the socio-demographic data and trust in health facilities (P < 0.05). There was a significant relationship between trust in the health facility and the provision of clear accessible policies and protocols with regard to infection prevention and control, personal protective equipment and support (P = 0.003). There was no relationship between trust in health facilities and location of health facility, job role or gender. CONCLUSION: Clear accessible communication on policies and protocols, as well as the provision of personal protective equipment and support, would contribute greatly to trust in health facilities and the health system and can help curb the COVID-19 pandemic.
  719 81 -
MWAN BIENNIAL CONFERENCE, ASABA 2019 — BOOK OF PROCEEDINGS
Speech by the Honourable Minister of State for Health Dr. Olurunnimbe Mamora

June 2021, 6(1):45-46
  728 69 -
Maternal & Neonatal Tetanus Elimination
Angela A. Okolo
June 2021, 6(1):47-52
  730 66 -