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Objectives Pregnancy carries a high risk for millions of women and varies by urban-rural location in Nigeria, a country with the second highest maternal deaths in the world. Addressing multilevel predictors of poor pregnancy outcomes among antenatal care (ANC) attendees in primary health care (PHC) facilities could reduce the high maternal mortality rate in Nigeria. This study utilised the 'Risk Approach' strategy to (1) compare the risks of poor pregnancy outcomes among ANC attendees by urban-rural location; and (2) determine predictors of poor pregnancy outcomes among ANC attendees in urban-rural PHC facilities in Cross River State, Nigeria. Methods A cross-sectional survey was conducted in 2011 among 400 ANC attendees aged 15-49 years recruited through multistage sampling. Data on risk factors of poor pregnancy outcomes were collected using interviewer-administered questionnaires and clinic records. Respondents were categorised into low, medium or high risk of poor pregnancy outcomes, based on their overall risk scores. Predictors of poor pregnancy outcomes were determined by multilevel ordinal logistic regression. Results A greater proportion of the women in the rural areas were below the middle socio-economic quintile (75 vs. 4 %, p < 0.001), had no education (12 vs. 2 %, p < 0.001), and were in the 15-24 age group (58 vs. 35 %, p < 0.001) whereas women in the urban areas were older than 35 years (10 vs. 5 %, p < 0.001). The women attending antenatal care in the urban PHC facilities had a low overall risk of poor pregnancy outcomes than those in the rural facilities (64 vs. 50 %, p = 0.034). Pregnant women in the urban areas had decreased odds of being at high risk of poor pregnancy outcomes versus the combined medium and low risks compared with those in the rural areas (OR 0.55, 95 % CI 0.09-0.65). Conclusions for Practice Pregnant women attending antenatal care in rural PHC facilities are more at risk of poor pregnancy outcomes than those receiving care in the urban facilities. Health programmes that promote safe pregnancy should target pregnant women in rural settings., Author(s): Soter Ameh[sup.1] [sup.2] , Omokhoa A. Adeleye[sup.3] , Caroline W. Kabiru[sup.4] , Thomas Agan[sup.5] , Roseline Duke[sup.6] , Nkese Mkpanam[sup.1] , Doris Nwoha[sup.7] Author Affiliations: (1) Department of Community [...]

Introduction: In Nigeria, immunisation with coronavirus disease 2019 (COVID‑19) vaccines commenced in March 2021. COVISHIELD from AstraZeneca (AZ), a viral vector vaccine, was the brand administered in the first phase of vaccinations for pre‑determined eligible adults 18 years and above. As more brands of COVID‑19 vaccines have been introduced in Nigeria, identifying effective and safe vaccine brands is essential to pharmacovigilance and public health. The current study assessed the safety of the AZ‑AZD1222 (ChAdOx1) COVID‑19 vaccine in adults during the first phase of the vaccination exercise in Nigeria. Methodology: We conducted a descriptive analysis of safety data from selected vaccination sites across six states in Nigeria between June 2021 and September 2021. Respondents were monitored over 3 months for local and systemic reactions, as well as hospitalisation and mortality. Measures obtained from respondents include age, sex, pre‑existing comorbidity, local and systemic reactions to vaccines, timing onset of reactions, hospitalisation and mortality. Bivariate and multivariable regression models were used to assess factors associated with vaccine reactogenicity. Results: A total of 1284 individuals were enrolled in the cohort study from the six selected states (Anambra, Borno, Edo, Katsina, Lagos and Plateau) representing the geopolitical zones of Nigeria. A total of 675 individuals or 52.6% of enrolees reported non‑serious adverse effects, and only one individual or 0.08% reported a serious adverse event following immunisation in the first 7 days after vaccination. None of the enrolled participants reported adverse events requiring hospitalisation. The most common self‑reported symptoms amongst vaccine recipients were tenderness at the injection site 20.9% and fever 20.3%. A majority of symptoms (55.5%) occurred on or before the 3rd day after vaccination. Multivariable logistic regression model showed that age 60 years or above (vs. 18–24 years) was significantly associated with a lower likelihood of a vaccine‑related symptomatic reaction (adjusted odds ratio: 0.35; 95% confidence interval: 0.20–0.61). There was no reported mortality amongst all the enrolled and followed‑up vaccine recipients. Conclusion: Our findings suggest that the safety profile of the AZ vaccine is acceptable, and the observed symptoms were mild and mostly within the first 3 days following vaccination. Vaccine recipients will benefit from counselling about potential transient reactions, and improving public awareness can potentially encourage the uptake of vaccines and reduce the spread of the COVID‑19 pandemic. [ABSTRACT FROM AUTHOR]

Background: In developing countries, men are sometimes stereotypically perceived as uninterested in maternal health, but their reproductive health roles have been widely recognized. Some studies have suggested that effective communication with men on safe motherhood can yield behavior changes capable of reducing maternal deaths. Aim: This study's objective was to study the impact of an educational session on the knowledge and attitudes of married men regarding maternal deaths. Design: Men were interviewed before the intervention and then participated in a joint educational session on safe motherhood. Follow-up interviews took place three months after the intervention. Results: 141 randomly selected men enrolled in the study; 122 completed both interviews. After the session, men were more likely to recognize a danger sign of pregnancy and delivery, but there was no increase in their willingness to participate in making the local hospital better for maternal healthcare. Mean composite scores increased significantly. Conclusions: Married men have moderate knowledge about maternal deaths and are potentially educable regarding their prevention. Further controlled intervention programs and studies are recommended. [ABSTRACT FROM AUTHOR]

Objectives: The study aimed at determining final year medical students' anticipated specialty choices, the factors they consider important in choosing a specialty and the interrelationship between these variables. Methodology: In a descriptive cross-sectional survey, questions on specialty preferences and influencing factors were asked, using structured self-administered questionnaires. Results: The specialty preferences included: surgery (50.7%), obstetrics and gynaecology (43.9%), paediatrics (20.6%), community health (17.6%) and adult medicine (14.5%). The proportions of preferred specialties did not 'fit' those of recent graduates of the National Postgraduate Medical College (p=0.00). The major influencing factors were personal interest (67.2%), potential for high income (22.0%) and perceived benefit to the society (14.9%). Potential for high income was a major factor associated with all the specialties except community health. Personal interest was a major factor associated with all the specialties except anaesthesia. Conclusion: The findings call for career education and counselling to empower students in specialty choice decisions. They also provide a basis for systematic and proportionate manpower development in medical specialties by relevant stakeholders in order to meet personal and national needs. The study indicates opportunities for further research. [ABSTRACT FROM AUTHOR]