Are Female Undergraduates at the University of Calabar Equipped with the Knowledge, Positive Attitudes, and Effective Practices of Contraceptives?

BACKGROUND: The global challenge of rapid population growth necessitates family planning programs to address reproductive health needs and control population increase. However, unintended pregnancies, particularly among adolescents, remain a significant problem, leading to increased risks of sexually transmitted infections and unsafe abortions. In Nigeria, contraceptive use is low among youths, resulting in high incidences of induced abortions and sexually transmitted infections. Barriers such as religious beliefs, cultural factors, limited availability, personal beliefs, and fear of side effects contribute to the under-utilization of contraceptives. METHODS: A descriptive cross-sectional study was conducted among female undergraduates of the University of Calabar, Cross River State. Data was collected using a 42-item questionnaire after obtaining informed consent. Multi-stage sampling was employed, and data was analyzed with IBM SPSS version 26 using descriptive and inferential statistics. RESULTS: The mean age of respondents was 21.5 ± 2.72 years. Most participants were in their first (26.7%) or second (22.6%) level of study. 28.8% were in sexual relationships, while 71.2% were not. Approximately a quarter of respondents had experienced symptoms of sexually transmitted infections. 71.5% had no knowledge of emergency contraception. Condoms (71.2%) and pills (54.5%) were the most commonly mentioned methods of contraception, while tubal ligation was the least popular (4.7%). The main benefit cited for contraception was the prevention of unwanted pregnancy (92.2%). 47.3% had no idea about the side effects of contraception, with irregular menstruation being the most commonly mentioned side effect (19.3%). Friends/peers, the internet, and school were the primary sources of information on contraception. 56.4% believed that contraception is not solely for females and should not be reserved for the literate. Over a third of respondents thought contraception encourages promiscuity and has too many side effects, with more than half demanding contraceptive services on campus. Less than half of the respondents (43.9%) reported using contraception at some point, with even smaller percentages using contraception in the last six months (25.2%) or during their last sexual intercourse (23.8%). Of the 101 who used contraceptives in their last sexual intercourse, the majority (83%) used condoms, while pills (7%) and emergency contraception (10%) were less common. Preferred sources for contraception were pharmacies (57.5%) and chemist shops/patent medicine vendors (24.7%). Religion (41.5%), fear of side effects (34.9%), and partner consent (28.3%) were the main influences on contraceptive use. Several factors were significantly associated with contraception utilization, including age, partner's educational level, knowledge of contraception, and level of study (p<0.05). CONCLUSION: The low utilization of contraception among female undergraduates at the University of Calabar despite high awareness and poor knowledge highlights the need for interventions. Factors influencing utilization include age, knowledge, and level of study. Barriers such as religion, fear of side effects, and partner consent must be addressed. Recommendations include sensitization campaigns, establishing a youth-friendly center on campus, incorporating contraception into curricula, collaborating with NGOs, and increasing funding for research

Mitigating Physician Emigration in Nigeria by Improving the Internship Experience

Nigeria faces a critical shortage of health workers, exacerbated by a growing of physician emigration. This study explored the negative internship experiences that drive Nigerian interns to migrate abroad, with a focus on the COVID-19 pandemic's impact. Interns cite excessive workload and burnout, lack of professional development opportunities, challenging work environment, and mistreatment as key reasons for considering emigration. The COVID-19 pandemic has exacerbated these challenges, leading to shortages of personal protective equipment, limited screening services, and poor hazard allowances. The paper emphasizes the importance of adopting policies that make destination countries attractive to emigrating interns. These includes creating a supportive work environment with fair compensation, professional development opportunities, and adequate resources to retain interns in the country. It also highlights the significance of addressing mistreatment and bullying in the workplace. Collaboration between healthcare organizations, policy reforms, and increased healthcare financing are suggested as potential strategies to mitigate the brain drain and ensure a sustainable healthcare system in Nigeria. Improving internship conditions and addressing the shortcomings of managing the COVID-19 pandemic are essential to retaining Nigerian doctors and combatting physician emigration. This requires a coordinated effort from healthcare systems, policymakers, and stakeholders

Exploring Sports Betting Prevalence, Patterns, Effects, And Associated Factors Among Undergraduate Students in a Nigerian University — A Cross-Sectional Study

BACKGROUND: The rise of legalized gambling, fueled by technology and social media, has transformed betting into a risky economic activity that promises income. In Nigeria, sports betting has become increasingly popular among youths, particularly university students, with easy online access contributing to its prevalence. However, inadequate awareness of its risks and impact on academics persists due to the perception that sports betting lacks overt physical manifestations. Research is needed to increase understanding of sports betting's patterns, correlates, and impact, especially among undergraduates. AIMS: This study aimed to shed light on the prevalence, patterns, and implications of sports betting among undergraduates at the University of Calabar, to foster comprehensive solutions to address its negative consequences on academic performance and overall well-being. METHODS: A cross-sectional study was conducted on undergraduate students of a federal University in Nigeria. Multistage randomized sampling was utilized to recruit 406 participants for the study. Seventeen departments were selected using simple random sampling, and one class was chosen from each department through balloting, resulting in a total of 17 classes. Proportional allocation was used to determine the number of participants required from each class, and systematic sampling was employed to select the participants. Data was collected using a standardized questionnaire adapted from the British Gambling Prevalence Survey, with the Problem Gambling Severity Index used to assess the prevalence of problem gambling and the effects of sports betting on bettors. Motivations for sports betting were assessed using the Reasons for Gambling Questionnaire. The impact of sports betting on academics was evaluated using a separate set of questions. Data were analyzed using IBM SPSS version 26; p-values less than 0.05 were considered significant. RESULTS: Out of 406 undergraduate respondents, 36.7% had engaged in sports betting, with 30.3% participating in the past year. Among past-year gamblers, 21.9% bet as frequently as 2-3 days a week, 18.7% bet 2-3 days a month, and 15.40% bet daily. Football was the preferred sport for 95.9% of sports bettors. Two-thirds of past-year gamblers used online platforms for betting, while 32.5% utilized land-based venues. Most sports bettors (87.8%) were motivated by monetary consideration, while 10.5% did so out of fear of missing out. Advertisements influenced 56.1% of respondents' decisions to place bets. Problem gambling prevalence was 14.3% in the study population and 47.2% among past-year gamblers. Negative academic impacts were reported by 64.2% of past-year gamblers. In bivariate analysis, a p-value <0.05 was considered significant, and age, sex, and monthly income had a significant relationship with lifetime gambling prevalence. Sex and socioeconomic status were significantly associated with problem gambling. Regular gambling was significantly related to academic performance. CONCLUSION: Gambling is prevalent among undergraduates and a significant proportion develop addictive disorders like problem gambling requiring mental health rehabilitation. This study underscores the necessity of interventions, regulations, and support services to tackle the prevalence and consequences of sports betting among students. Recommendations include education campaigns, age verification, financial literacy programs, and support groups to empower students and address potential negative impacts.

Knowledge, Attitude and Use of Contraceptives Among Women of Reproductive Age in a Nigerian Rural Community

BACKGROUND: The use of contraception, encompassing various methods such as hormonal pills, condoms, intrauterine devices, and natural techniques like abstinence, plays a pivotal role in family planning and reproductive health. Despite its importance, the utilization of contraceptives, particularly in low-resource nations like Nigeria, has remained notably low. This is concerning, considering the positive impact of contraception on maternal and child health and its contribution to national development by curbing population growth. In Nigeria, awareness of contraception is relatively high, but the adoption of modern contraceptive methods is alarmingly low, with only 10% of females utilizing them. This rate is notably insufficient given the high levels of sexual activity, especially among adolescents and young adults. Furthermore, regional disparities exist within Nigeria, with the south-south geopolitical zone exhibiting a higher prevalence of modern contraceptive use at 15.5%. Factors influencing contraceptive usage include education, religious beliefs, and awareness of available methods. In Yenagoa, Bayelsa state, the prevalence of modern contraceptives was notably higher at 36.8% in 2017, underscoring the impact of education and knowledge of contraceptive options. Increasing contraceptive use is crucial for Nigeria, a lower-middle-income country, as it not only aids in averting unplanned pregnancies and maternal mortality but also in controlling population growth. AIM: The study aimed to shed light on contraceptives' profound health advantages to both women and families. By investigating the knowledge, attitude, and use of contraceptives within the context of the study community, it sought to contribute to the promotion and enhancement of contraceptive use among women of reproductive age in the rural community of Sagbama, South-south Nigeria. METHODS: A descriptive cross-sectional study was conducted among women of reproductive age, over a period of 3 months in Sagbama Community, Bayelsa state. Multi-stage sampling was employed. Data was obtained using interviewer-administered semi-structured 31-item questionnaire and analyzed using IBM SPSS version 26. Bivariate analysis with p-value <0.05 was significant. RESULTS: Among the 314 respondents, the mean age was 29.96 years. Nearly half were married (48.4%), with varying numbers of children. The majority had some form of education, with 46.8% having secondary education. Most respondents (95.9%) had heard of contraceptives, primarily from friends (76.4%) and hospitals (58%). The most well-known contraceptive methods were male condoms (95.9%), contraceptive pills (79.9%), and implants (72.3%). Positive attitudes toward contraceptive use were observed in 83.4% of respondents, driven by the desire to prevent unwanted pregnancies and space births (80.9%). Of sexually active women (81.4%), 53.3% used contraceptives, with male condoms (44%) and pills (15.7%) being the most common methods. Reasons for non-use included a perceived lack of need (28.6%) and fear of side effects (26.5%). CONCLUSION: Despite high knowledge levels, the use of contraceptives among women of reproductive age in the community was poor. Education and addressing misconceptions are essential to promote effective contraceptive use. Comprehensive health and sex education involving both men and women should be provided to dispel misconceptions and encourage correct contraceptive use

Beating the odds: Rare prolonged survival of truncus arteriosus: A case report with literature review

Rationale: Truncus arteriosus is a cyanotic congenital heart disease in which the great vessels of the heart fail to separate in utero. Consequently, a single truncal vessel arises from the heart to supply the systemic, coronary, and pulmonary circulations. This lesion causes the total mixing of oxygenated and deoxygenated blood, with an early onset of pulmonary vascular disease. Patients rarely survive beyond the first year of life. This case report highlights a rare survival without intervention up to the ninth year of life. Patient concerns: We present the case of a 9-year-old male child with a history of dark discoloration of the lips and digits, easy fatigability, and fast breathing since birth. The patient is currently small for his age, with a bulging anterior chest wall, displaced apex beat, and cardiac murmur. Oxygen saturation was 57% in room air. A chest radiograph showed peri-hilar lymphadenopathy with prominent pulmonary trunks. Pack cell volume was 62%, and the gene expert test was negative. Diagnoses: A diagnosis of cyanotic congenital heart disease, truncus arteriosus type III with pulmonary hypertension, was made after diagnostic evaluation with echocardiography. Interventions: To manage congestive heart failure, the patient was put on diuretics, including furosemide and spironolactone. Parents could not carry out a definitive surgical repair due to financial constraints. Outcomes: Although the patient was able to survive the past year, the child had developed cardiomegaly, signs of pulmonary congestion, decreased oxygenation, and a compensatory increase in red blood cell volume. Lessons: Truncus arteriosus is a critical congenital heart defect that has a high potential for morbidity and mortality within the first year of life. It requires immediate intervention and surgical repair in the immediate neonatal period. In rare cases, patients have been able to survive beyond the first year, especially if they also developed pulmonary stenosis. However, this patient had been a survivor for 9 years without another structural anomaly. Given the unique presentation and its rarity, further research is needed into compensatory mechanisms and possible low-cost and accessible alternatives in resource-constrained settings. It also demonstrates that pharmacologic therapy alone is insufficient to prevent mortality

Knowledge, Attitude, and Prevalence Towards Cervical Cancer Screening Among Women in a Nigerian Urban Municipality

BACKGROUND: Cervical cancer is a significant global health concern, particularly in less developed regions, ranking as the fourth most common cancer among women. Nigeria faces its crisis, with approximately 15,000 women diagnosed annually, resulting in a two-thirds fatality rate. An alarming 40 million Nigerian women remain at risk, underscoring the urgency of improved screening and disease surveillance, compounded by the absence of a national cancer policy and limited awareness. Cervical cancer can be reduced by more than 90% through regular screening. It is caused by sexually transmitted HPV and risk factors include multiple sexual partners, smoking, long-term oral contraceptive use, and immunosuppression. AIM: The study aimed to ascertain the knowledge, attitude, and practices toward cervical cancer screening and the factors that influence the practice of screening among women of the reproductive age group in Calabar Municipality. METHODS: Using a cross-sectional study design, 414 women were enrolled from two public hospitals, four private hospitals, and a non-governmental women’s center through a meticulous multi-stage sampling technique, employing semi-structured questionnaires. Socio-demographic variables were collected, and a 31-item questionnaire was used to assess the level of knowledge, attitudes, and practices toward cervical cancer. Data were analyzed using IBM SPSS version 26; p-values less than 0.05 were considered significant. RESULTS: The mean ages of respondents were 28.01 ± ((8.8357), 293 were single, while 107 were married. 69.67% had received at least tertiary education. 51.9% were employed, and the rest were unemployed. All 414 respondents were familiar with cervical cancer, but 65.7% lacked adequate knowledge of screening. Approximately 60% were aware of screening tests, with health workers as their primary information source. Most women displayed a favorable attitude toward screening; 97.3% expressed willingness if the procedure was explained and accessible, 96.4% if it was free and safe, and 97.6% supported screening for women under 30 years. Unfortunately, only 8% had undergone screening, with Pap smears as the commonest screening method for 84.8% of those who had received screening. Out of 381 respondents who had never been screened, 101 did not think they were at risk, 89 did not know where to get screened, 75 believed their religion protected them, and 37 found it expensive. In bivariate analysis, age, marital status, employment status, and knowledge of screening significantly correlated with good practice (p<0.05). CONCLUSION: The underutilization of screening services in an urban setting is concerning, signaling the potential for cancer care disparities in rural areas. Urgent interventions are needed to foster more favorable attitudes and practices, particularly in developing countries like Nigeria, where cervical cancer remains a leading women's health concern. With Nigeria's limited healthcare financing and fragile health system, cervical cancer screening promotion is crucial. Community-based strategies should be utilized to promote screening, and medical outreaches organized to eliminate healthcare barriers. The government should increase funding for the health sector and provide more screening centers while empowering healthcare providers

Addressing vaccination gaps among healthcare workers in sub-Saharan Africa: the role of mandatory Hepatitis B vaccination

Abstract Hepatitis B virus (HBV) poses a significant public health threat, particularly in developing countries with high endemicity but poor vaccination among healthcare workers (HCWs). Needlestick injuries increase HCWs' risk, yet only about 42% of HCWs are fully vaccinated compared to 97% in high-income countries. Challenges to vaccine uptake include availability, demanding schedules with frequent unit rotations hindering access, high cost of acquiring shots, and stock shortages resulting in missed opportunities. Mandatory, cost-free HBV vaccinations for HCWs, supported by legislation, international aid, and digital reminders, could ensure self-protection and safety while contributing to the global objective of eradicating HBV by 2030

Prevalence, patterns, correlates, and academic implications of sports betting and problem gambling among Nigerian undergraduates

Abstract Background Sports betting has become increasingly popular among Nigerian undergraduates, particularly males. Once a recreational activity, sports betting has now become an economic pursuit for many young students to augment income. This trend raises concerns about its potential impact on academic performance and mental health. This study examined the patterns, correlates, academic implications, and predictors of sports betting and problem gambling among University of Calabar undergraduate students. Methods A cross-sectional analytical study was conducted among undergraduate students at the University of Calabar using a self-administered questionnaire. Data on gambling behaviour, problem gambling severity, reasons for gambling, and demographic information were collected using the Reasons for Gambling Questionnaire (RGQ) and the Problem Gambling Severity Index (PGSI). The impact of sports betting on participants’ academic performance was also assessed. Data was analysed using SPSS Statistics v25, employing descriptive statistics, bivariate analysis, and logistic regression. Results Among 406 respondents, 36.7% had engaged in sports betting, with 30.3% participating in the past year. One underage bettor was identified. Males (83.2%) were more likely to bet. Two-thirds of respondents preferred online sports betting. The primary motivation behind sports betting was monetary gain (87.8%), followed by recreational purposes (47.1%) and thrill-seeking (45.1%). Problem gambling prevalence was 14.3%, increasing to 47.2% among those who had gambled in the previous year. Negative academic impacts were reported by 64.2% of respondents who gambled in the year prior. Strong evidence of an association between male gender and higher income with sports betting and problem gambling was identified (p < 0.05). Gambling frequency had strong evidence of association with adverse academic effects (p < 0.01). Problem gambling was associated with spending study time on sports betting (60.7%) or following sports betting games (75%) (p < 0.001). Logistic regression showed strong evidence of an association between advertisement influence and problem gambling, with those influenced by exposure to gambling adverts being four times more likely to have problem gambling (OR 4.36, 95% CI 1.93–9.86). Conclusion The study revealed a high prevalence of sports betting and problem gambling among Nigerian undergraduates. Academic impacts were also evident, highlighting the need for targeted interventions. We recommend developing and implementing educational campaigns, financial literacy programs, and support services for at-risk individuals. Additionally, regulatory measures to restrict the advertising and marketing of sports betting to minors and vulnerable populations should be considered

The burden of menstrual irregularities among women living with HIV in Nigeria: a comprehensive review

Abstract Background Menstrual irregularities significantly distress women living with HIV (WLHIV), impacting their reproductive health and quality of life. Although the underlying mechanism remains inconclusive, studies have outlined possible contributory factors. This narrative review explores the burden of menstrual irregularities and associated hormonal dysregulation among women living with HIV in Nigeria. It synthesises data from studies to present an overview of the prevalence, patterns, potential etiology, and impacts of menstrual irregularities among WLHIV. Main body A literature search across electronic databases such as PubMed, Google Scholar, and Web of Science was conducted, and information was extracted and synthesized to delineate the burden of menstrual irregularities in WLHIV. Eligibility criteria included original studies assessing the prevalence, aetiology, and impact of menstrual abnormalities among WLHIV in Nigeria. A narrative data synthesis approach utilized common themes and key concept extraction, including identifying patterns in the literature to present specific trends such as prevalence, patterns, etiology, and determinants. Menstrual irregularities were found to be prevalent among Nigerian WLHIV, varying from 29 to 76% across different regions, exceeding reports of similar studies in developed nations. Similarly, menstrual disorders including amenorrhea, oligomenorrhea, and polymenorrhea, were attributed to factors like HIV acquisition, antiretroviral therapy, low body mass index, and hormonal imbalances. Low CD4 count and high viral load with associated complications have been identified as major contributing factors. Distortion of the hypogonadal-pituitary-ovarian axis by viral-induced pro-inflammatory cytokines such as tumor necrosis factor-alpha (TNF-α), interleukin-1 (IL-1), interleukin-6 (IL-6), and interferon-gamma (IFN-γ) may disrupt the hormonal balance necessary for regular menstrual cycles. Fluctuating levels of follicle-stimulating hormone (FSH), luteinising hormone (LH), estradiol, and prolactin have been reported among WLHIV. Although adherence to antiretroviral therapy has offered immense relief, its direct therapeutic effects on menstrual irregularities are inconclusive.. Conclusions This study highlights the burden of menstrual disorders among WLHIV. It underscores the interplay between clinical, therapeutic, and client-associated factors as determinants of these abnormalities. Exploring associated complications like secondary infertility, reduced bone mineral density, and resultant osteoporosis, mirrors the significant impact of menstrual and hormonal irregularities on the reproductive health and quality of life of WLHIV