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Biomedical subjects

E E Ekanem

Publications and source records attributed to E E Ekanem.

At least 19 recordsLinked to original sources
PubMed2006

Knowledge and practice of emergency contraception among female undergraduates in the University of Lagos, Nigeria.

OBJECTIVES: To assess the level of knowledge and practice of emergency contraception among female undergraduates in University of Lagos and to determine the factors that influence knowledge and practice of emergency contraception among female undergraduates. DESIGN: Cross-sectional descriptive study. SETTING: The University of Lagos, Lagos, South-West, Nigeria between August 2003 and March 2004. SUBJECTS: Four hundred and eighty randomly selected female undergraduate students. RESULTS: The findings revealed that 67.8% of the respondents reported knowing about emergency contraception. More than half (56.1%) were sexually active and of this group, 96.8% had ever practiced contraception with only 33.9% having ever practiced emergency contraception. However, only 37.8% and 36.3% of respondents who had reported knowing about emergency contraception knew the correct time frame for effective use, and correctly identified emergency contraceptives respectively. Among those who were aware of, and had used emergency contraception, 34.1% obtained their information from health care providers, while the larger majority obtained from friends. Knowledge and practice of emergency contraception was found to be directly related to age, level of study, medical education, marital status, sexual activity, previous history of use of contraceptives and previous history of induced abortion. CONCLUSION: Education efforts that focus on the training of health care providers and young adults on emergency contraception with regards to available methods and correct timing of use would greatly improve women's access to and effective use of this method in Nigeria.

Adolescent↗
PubMed2005

Contraceptive prevalence among young women in Nigeria.

In almost all societies in the world there is an increase in sexual activity among young persons (10-24 years). There is a need for contraceptive use among them to prevent high risk unintended pregnancies. This study was carried out to determine the contraceptive prevalence among young women in Nigeria. The study population was 832 young women between the ages of 15 and 24 years. Only 11.1% of the respondents had ever used contraceptives although 63.2% of them had had sexual intercourse. Contraceptive usage was significantly higher (p<0.05) among the single sexually active women (38.5%) than among the married women (7.7%). Only 7.3% of respondents are currently using a contraceptive method. The main methods in use were condoms and pills. There is an unmet need for contraceptives among young women in Nigeria. It is necessary to improve these young women's abilities to protect themselves against unwanted pregnancies.

Adolescent↗
PubMed2005

Sexual behaviour, HIV-related knowledge and condom use by intra-city commercial bus drivers and motor park attendants in Lagos, Nigeria.

A study was undertaken among 395 intra-city commercial bus drivers, conductors and motor park attendants in a sub-urban community in Lagos, Nigeria. It was aimed at ascertaining the level of knowledge of the participants on sexually transmitted diseases including AIDS, their sexual practices and perceived vulnerability to these diseases and, in particular, their attitude to and use of condoms. A semi-structured interview schedule was used for data collection. The men were found to have a strongly woven network of sexual relationships. Their sexual network included, apart from their wives and regular partners, commercial sex workers, young female hawkers, schoolgirls, and market women within and outside the motor parks. More than two thirds (74.3%) of the men had multiple sex partners and many of them had had sexually transmitted diseases at one time or another. Condom ever-use rate was 65.6% but consistent and regular use rate with casual partners was 11.6%. Almost all the respondents (96.4%) knew themselves to be at high risk of contracting STDs, while 87.6% felt that it was impossible for them to "catch" AIDS. Poor knowledge of risk factors for STDs was exhibited, as many of them attributed their previous STDs to excessive exposure to the sun, having sex in the sun, and their partners remaining in the bath for too long. Intra-city commercial bus operators and men at motor parks are a high risk group for acquiring HIV infection. Their sexual networking with a variety of women within and outside the parks also seems to suggest that they play a major role in transmitting HIV infection in urban communities in Nigeria. There is a need for intervention programmes with a focus on men at motor parks and similar high risk groups.

Acquired Immunodeficiency Syndrome↗
PubMed2004

Voluntary counselling and testing (VCT) for Human Immunodeficiency Virus: a study on acceptability by Nigerian women attending antenatal clinics.

This study was carried out among 345 pregnant women attending antenatal clinics at two health facilities in Lagos, Nigeria. It was undertaken to determine their knowledge and acceptability of HIV voluntary counselling and testing in pregnancy as a strategy for the prevention of mother-to-child transmission (PMTCT) of HIV. Data were collected on issues relating to mother-to-child transmission of HIV, willingness to go for voluntary counselling and testing, actions to be taken if a pregnant woman was found to be HIV positive including infant feeding options. Majority of the women (89.9%) had good knowledge of the modes of HIV transmission, however, knowledge of specific aspects of PMTCT was poor. Close to half of the women (41.7%) were not aware of the association between breast milk and HIV transmission. Almost all the women (96.1%) were willing to undergo HIV testing in pregnancy particularly if it would assist preventing transmission of HIV to their babies; but only few would undergo the test if the result would be shared with relatives. Many of the women would still prefer breastfeeding even if they were found to be HIV positive. Awareness of anti-retroviral drugs among the study group was very poor. As the country is about to embark on its PMTTCT programme, there is need to increase the level of knowledge, acceptability and adoption of VCT and other PMTCT strategies among potential beneficiaries. Innovative information and education techniques need to be developed to provide HIV positive mothers with knowledge and skills that can enable them to make informed choices about infant feeding options and other forms of care.

AIDS Serodiagnosis↗
PubMed2001

Features of childhood hepatic failure in Calabar, Nigeria.

The features in 21 patients with childhood hepatic failure studies retrospectively over a seven year period at the University of Calabar Teaching Hospital, Calabar, Nigeria are presented. Of the 21 patients, 71.4 per cent were aged three years nd below. Fulminant hepatic failure occurred in 81.0 per cent of the patients while in 19.0 per cent, the failure resulted from chronic liver disease. Hepatitis B infection alone or in association with other factors was the major cause of the condition, occurring in 76.2 per cent of the cases. The main complications were severe anaemia (23.8%), septicaemia (23.8%) and pneumonia (19.0%), renal failure (9.5%). With only one survival, the case fatality rate was 95.2 per cent. For prevention of the condition in Nigeria, universal mandatory screening of blood and blood products for hepatitis B markers before transfusion and the integration of hepatitis B vaccination into the National Expanded Programme on Immunization are strongly recommended.

Age Distribution↗
PubMed2000

Factors affecting mortality and morbidity in patients with abdominal gunshot wounds.

Risk factors that may independently predict mortality and morbidity in patients with abdominal gunshot wounds have not been fully elucidated. We prospectively studied the effects of 12 potential risk factors on mortality and morbidity in 82 patients with abdominal gunshot wounds who required laparotomy. Univariate analysis of these factors revealed that shock on admission, presence of penetrating colon injury and number of intra-abdominal organs injured (NOI)>2 were associated with greater than threefold increased incidence of death (p<0.05). Penetrating abdominal trauma index (PATI) score>15 was associated with twentyfold increased incidence of death (P<0.0001). Multivariate analysis showed that only PATI (P=0.001), number of postoperative complications per patient (N(comp)) (P=0.023) and presence of shock on admission (P=0. 028) were independently significant in predicting mortality. PATI was the only risk factor that independently predicted the development of postoperative infectious complications and N(comp) (P<0.0001). The type of gun used was not a significant risk factor (P>0.05). The 15 (18.3%) non-survivors were significantly older than survivors (P=0.02), had longer operations (P=0.004) and their NOI, PATI and N(comp) were significantly higher (P<0.001). The uniformly prolonged injury to surgery time in all patients contributed to the high incidence of infectious complications (62.2%) and mortality. PATI score was the most important factor found to be independently associated with mortality and morbidity in our subset of patients with prolonged injury to surgery time and high rate of colon injury.

Abdominal Injuries↗
PubMed2000

Unprecedented decline in measles morbidity and mortality in Calabar, south-eastern Nigeria.

The features of measles presenting at the University of CalabarTeaching Hospital, in south-eastern Nigeria between January 1992 to December 1996, were compared with those of a previous period (January 1984 to December 1987) in the same institution. The aim was to detect any changes in trends, morbidity and mortality from the infection in this environment. There were only 36 cases (7.2 per year) in the current period compared with 436 (109 per year) in the previous period (chi2=48.4, P<0.001). There were also highly significant falls in the incidence of malnutrition and bronchopneumonia (P<0.05) in the current period. Notably, there were no cases of dehydration or keratomalacia in the current period. The case fatality rate was 2.8% compared with 20.0% in the previous period (P<0.02). These unprecedented changes in the incidence, morbidity and mortality from measles are attributed to the continuing Expanded Programme on Immunization, oral rehydration therapy, appropriate nutritional management and vitamin A prophylaxis. With maintenance and strengthening of these strategies, the elimination of measles and measles deaths in the near future is feasible in this environment.

Age Distribution↗
PubMed1997

Seroprevalence and coprevalence of HIV and HBsAg in Nigerian children with/without protein energy malnutrition.

In order to assess the seroprevalence and coprevalence of hepatitis-B surface antigen (HBsAg), human immunodeficiency virus-1 and -2 (HIV-1 and -2) antibodies in Nigerian children with/without protein energy malnutrition (PEM), we studied plasma specimens of 206 children with PEM and 200 apparently healthy reference children aged between 1 and 3 years by enzyme-linked immunosorbent assays (ELISA). HIV-seropositive cases were confirmed by immunoblotting (IB). Of the children studied, eight (4%) of the healthy and four (1.9%) of the malnourished (P = 0.22, Fisher's exact test) were positive for HIV-1 antibodies, 40 (20%) of the healthy and 54 (26%) of the malnourished (P = 0.14) were positive for HBsAg, and five (2.5%) of the healthy and four (1.9%) of the malnourished (P = 0.70) were positive for both HIV-1/HBsAg. No case of HIV-2 antibodies was found. While the seroprevalence of HBsAg was higher in the malnourished subjects, the reverse was the case with HIV antibodies. However, all the four HIV-1-positive malnourished children and five of eight of the HIV-1-positive reference children were simultaneously positive for HBsAg. This is the first epidemiological report on the seroprevalence and coprevalence of HIV and HBsAg in apparently healthy and malnourished Nigerian children.

Child, Preschool↗
PubMed1997

Assessment of plasma fibronectin in malnourished Nigerian children.

BACKGROUND: Severe malnutrition is associated with septic infections. The concentrations of fibronectin, albumin, and transferrin in plasma were measured in three groups of children with protein-energy malnutrition, aged 1-3 years, each group comprising 20 children. The aim of which was to test whether plasma fibronectin, being an opsonic protein, was reduced in such children, and if it was a useful index for assessing the severity of malnutrition. METHODS: The concentrations of fibronectin, albumin, and transferrin in plasma were studied by enzyme immunoassay/ immunoblotting, spectrophotometry and immunoturbidimetry respectively. RESULTS: All values were significantly lower in the patients with malnutrition than in the age- and sex-matched well-nourished Nigerian reference children. Within the malnourished group, the fibronectin value was evenly reduced in all subgroups. Albumin and transferrin values were lowest in the patients with kwashiorkor, highest in the marasmic patients, and intermediate in the patients with marasmic kwashiorkor; the values correlated mutually in individual cases as well, but not with the fibronectin levels. Neither plasma fibronectin fragmentation nor tissue fibronectin was detected in any patient with malnutrition or in the reference subjects. CONCLUSIONS: The reduced plasma fibronectin values in these patients may be due to reduced synthesis by the liver, as evidenced by the equally reduced albumin and transferrin concentrations and/or to the multiple infections characteristic of the patients.

Biomarkers↗
PubMed1997

Serum C-reactive protein and C3 complement protein levels in severely malnourished Nigerian children with and without bacterial infections.

Bacterial infections are the major determinants of fatality in severe protein-energy malnutrition (PEM). Unfortunately, these infections are difficult to diagnose clinically. C-reactive protein (CRP) levels were determined in 17 infected and 10 non-infected Nigerian children with severe PEM and compared with age/sex-matched apparently healthy controls. The aim was to study the response of this acute phase protein to bacterial infections as well as to assess its value in the diagnosis of infections in severe PEM. C3 complement protein levels were also determined in the same group of subjects. The major organisms isolated in samples from these subjects were S. aureus and the coliforms. Mean CRP level in the non-infected children with severe PEM was 13.8 +/- 6.21 mg/l and rose to 159.83 +/- 124.07 mg/l in the presence of infection. The mean value in healthy non-infected controls was 2.01 +/- 0.96 mg/l. The difference in the mean CRP levels between the infected and non-infected PEM children was statistically significant at p < 0.01. The mean difference between the non-infected and the control subjects was not significant. Using a diagnostic level of 20.00 mg/l of CRP gave a sensitivity of 85.0% and a specificity of 80.0%. This CRP level is a useful index of bacterial infections in severe PEM. C3 complement protein was low in the non-infected malnourished group, but rose significantly in the presence of infection to values similar to that of the healthy controls. C3 protein thus behaves as an acute phase reactant in the presence of infection in severe PEM, and does not appear to be consumed, probably due to a deficiency in the early components of the complement cascade. This suggests a role for C3 measurement in the monitoring of bacterial infections in severe PEM.

Bacterial Infections↗
PubMed1995

Nutritional rickets in Calabar, Nigeria.

The features of 20 cases of nutritional rickets who presented at the University of Calabar Teaching Hospital, Calabar in south-eastern Nigeria over a 9-year period (January 1985-December 1993) are presented. The aim is to compare them with those in the only other reports from Nigeria between 18 and 42 years ago from Ibadan in the west of the country. The ages at presentation ranged between 6 months and 5 years with no sex preponderance. Most of the children were well nourished with the major features being delay in walking, swollen wrists and ankles and genu varum. The majority of cases in the present study occurred among children of elite and middle class parents who deprived their children of sunshine by keeping them indoors most of the day while they were at work. Reasons for the comparatively low prevalence of rickets in Calabar are social and cultural factors which enhance the exposure of children to sunlight. In addition, the relative availability of seafood and vegetables in this coastal city enhances rickets prevention.

Child, Preschool↗
PubMed1995

Urinary symptoms and blood pressure of children with Schistosoma haematobium infection in south-eastern Nigeria.

The urinary symptoms and blood pressures of 510 children (aged 5-15 years) with Schistosoma haematobium infection in Ijiman community, Cross River State of Nigeria, were studied in 1992. The prevalence rate of infection was 44%, a majority of the children presenting with light infection. Significant symptoms were visible haematuria, dysuria, suprapubic pain and strangury. The sensitivity and specificity of these symptoms were too low for them to be recommended as distinct clinical diagnostic criteria. The impact of the disease could not be demonstrated on blood pressures of the children. Nevertheless, urgent control measures with emphasis on the provision of ventilated improved pit toilets and potable water are strongly recommended for the control of the disease as persistent infection is known to mask manifestation of severe complications till an older age.

Adolescent↗
PubMed1994

Some environmental risk factors for childhood asthma: a case-control study.

A case-control study of the home environment of 140 asthmatic children and 140 controls (matched for age, sex and socio-economic status) was carried out in two semi-urban Nigerian teaching hospitals. The mean age of the children was 66 months, and the mean monthly family income was US $50.00. The average number of people in a household was seven, with a mean sleeping density of 4.9 persons per sleeping area. There was a strong and significant association between asthma and a damp, mouldy bedroom (OR = 11.2, p < 0.001), household pets (OR = 116.8, p < 0.001), cigarette smoke (OR = 2.1, p < 0.01), mosquito coil (OR = 3.7, p < 0.001), and rodents/cockroaches (OR = 113.7, p < 0.001). There was a curious but unexplained protective effect of indoor biomass smoke (OR = 0.6, p < 0.001), indoor plants (OR = 0.5, p < 0.01), mould growth elsewhere in the home (OR = 0.5, p < 0.01), and cosmetic aerosols (OR = 0.6, p < 0.05). Control of the micro- as well as the macro-environment of the asthmatic child as an adjuvant to drug therapy is discussed.

Animals↗
PubMed1994

Community-based surveillance of paediatric deaths in Cross River State, Nigeria.

A house-to-house survey of paediatric deaths which occurred from January to December 1991 in the village of Nko, Cross River State, Nigeria, was carried out. Among the 471 total deaths recorded, the leading causes were malaria (29%), protein-energy malnutrition, pneumonia and diarrhoeal disease (11% each). Neonatal deaths were largely due to septicaemia, tetanus and birth asphyxia. Poor domestic and human waste disposal, lack of portable water and basic health facilities appear to be the important related factors to child health problems in this community. The provision of public toilets, safe water, primary health care centres and health education can definitely improve the health status of this rural community. Events in other rural communities in Nigeria are most likely to be similar to that in Nko. Such populations need to be identified and their problems urgently addressed.

Adolescent↗
PubMed1994

Plasmodium falciparum malaria: its effects on some haematological parameters in normal and sickle cell Nigerian children.

The effect of Plasmodium falciparum malaria on the iron status was determined in 80 children: normal children without malaria (20) and with malaria (20), and sickle cell anaemia without malaria (17) and with malaria (23). Iron status was assessed using serum transferrin, serum iron, transferrin saturation and haemoglobin. The non-malaria sickle cell anaemia (SCA) group had lower transferrin (234.0 +/- 21.0) and haemoglobin (8.1 +/- 0.4) than non-malaria normal group (260.6 +/- 17.1 mg/100 ml, and 12.5% respectively). Serum iron was higher in sickle cell anaemia (125.1 +/- 17.1) than non-malaria normals (119.2 +/- 1 microgram/100 ml). Malaria caused an increase in serum transferrin, TIBC and serum iron in both normal and SCA children; these changes were more dramatic in normal than in SCA children.

Adolescent↗
PubMed1994

Effect of Schistosoma haematobium infection on the physical growth and school performance of Nigerian children.

A cross-sectional study of urinary schistosomiasis among 510 primary school children in Ijiman community in south eastern Nigeria was undertaken in May 1992. Schistosoma prevalence and intensity of infection including the impact of the disease on the physical growth and school performance of the subjects aged 5-15 years was assessed. Prevalence of Schistosoma haematobium was 44 pc with the rate rising progressively with age, with a peak prevalence at 10-15. The ova burden was of light intensity (1-49 ova/10 ml) in a majority (73 pc) of the cases. No significant impact of the disease could be demonstrated regarding anthropometric parameters, school attendance and academic performance among the infected children compared with the controls. The lack of discernable effect of S. haematobium infection on these parameters is similar to the general pattern in the west African sub region and is attributed to the generally light ova burden among these children. It is also suggested that differences in the strains of the parasite between regions may be important determinants of morbidity.

Absenteeism↗