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CONTEXT Nigeria has the second heaviest burden of Human Immunodeficiency Virus/ Acquired Immune Deficiency Syndrome (HIV/AIDS) in Africa. There is growing debate in favor of starting HIV/AIDS education early in life in order to equip pupils with the knowledge and skills to delay sexual debut and to utilize appropriate preventive measures thereafter. Objectives: To assess the knowledge and attitude of primary school pupils regarding HIV/AIDS and to determine their attitude towards People living with HIV/AIDS (PLWHAs). Materials and Methods A descriptive cross-sectional study carried out among primary schools pupils. A semi-structured self-administered questionnaire was used to collect data from 275 respondents in primary four to six. The study utilized multi-stage sampling method. Results Out of the 275 respondents recruited, 249 questionnaires were analyzable. Out of the 249 respondents, 116 (46.6%) were males while 133 (53.4%) were females. One hundred and eighty-seven (75.1%) respondents indicated that HIV /AIDS can be contracted through sexual intercourse; 50.1% indicated that it was caused by witches and wizards and 48% indicated that it was due to mosquito bite. More respondents in class six (11.7%) than those in class five (5.2%) and class four (0%) were willing to eat from the same plate with someone with HIV/AIDS. The difference was statistically significant (X2=9.547, df=2, P=0.008). Similarly, more respondents in class six (12.5%) than those in class five (6.4%) and class four (0.4%) indicated that they would live in the same room with someone with HIV/AIDS. The difference was statistically significant (X2=6.605, df=2, P=0.037). Conclusion Majority of respondents demonstrated gaps in knowledge of HIV/AIDS. Majority showed evidence of stigmatizing and discriminating attitude towards PLWHAs. Inclusion of HIV/AIDS education in the school curriculum and attitudinal re-orientation is recommended.

Context: Nigeria is presently one of only three countries in the world that are polio endemic. The immunization program in Nigeria has been marred by several factors including myths and misconceptions. Objective: The objective of this study was to identify myths and misconceptions that affect utilization of childhood immunization services in Calabar, Nigeria. Materials and Methods: Focus group discussion sessions were held among caregivers in Calabar, Nigeria. Each group consisted of 12 women of reproductive age. Data obtained from each session were transcribed and analyzed using the content analysis approach. Results: Participants had poor knowledge of vaccine preventable diseases (VPDs). Some mentioned non-VPDs as if they were VPDs. Some believed that “so called” VPDs are caused by mermaid spirits, witches and wizards. The solution to VPDs proffered by participants was sacrificing in the river by midnight. Some caregivers felt that multiple doses of vaccines could harm the children. With regard to polio, one caregiver said that “Polio is due to mammy water (water mermaid). The solution is not immunization. The solution is to sacrifice to the mermaid by 12 midnight in any river close to where the child was born, on the night of the child's birth. Once this is done, the child can never never have polio.” Conclusion: Myths and misconceptions regarding immunization are rife in most Nigerian communities. There is need to debunk them through health education in order to ensure success of the country's immunization program.

Background: Home management of uncomplicated malaria (HMM) is now integrated into the community case management of childhood illness (CCM), an approach that requires parasitological diagnosis before treatment. The success of CCM in resource-constrained settings without access to parasitological testing significantly depends on the caregiver's ability to recognise malaria in children under five years (U5), assess its severity, and initiate early treatment with the use of effective antimalarial drugs in the appropriate regimen at home. Little is known about factors that influence effective presumptive treatment of malaria in U5 by caregivers in resource-constrained malaria endemic areas. This study examined the factors associated with appropriate HMM in U5 by caregivers in rural Kassena-Nankana district, northern Ghana., Methods: A cross-sectional household survey was conducted among 811 caregivers recruited through multistage sampling. A caregiver was reported to have practiced appropriate HMM if an antimalarial drug was administered to a febrile child in the recommended regimen (correct dose and duration for the child's age). Binary logistic regression was used to determine factors associated with appropriate HMM., Results: Of the 811 caregivers, 87% recognised the symptoms of uncomplicated malaria in U5, and 49% (n = 395) used antimalarial drugs for the HMM. Fifty percent (n = 197) of caregivers who administered antimalarial drugs used the appropriate regimen. In the multivariate logistic regression, caregivers with secondary (OR = 1.71, 95% CI: 1.03, 2.83) and tertiary (OR = 3.58, 95% CI: 1.08, 11.87) education had increased odds of practicing appropriate HMM compared with those with no formal education. Those who sought treatment in the hospital for previous febrile illness in U5 had increased odds of practicing appropriate HMM (OR = 2.24, 95% CI: 1.12, 4.60) compared with those who visited the health centres., Conclusions: Half of caregivers who used antimalarial drugs practiced appropriate HMM. Educational status and utilisation of hospitals in previous illness were associated with appropriate HMM. Health education programmes that promote the use of the current first line antimalarial drugs in the appropriate regimen should be targeted at caregivers with no education in order to improve HMM in communities where parasitological diagnosis of malaria may not be feasible.

Objective: To determine the influence of patients' perception of obstetric practice in Calabar on the low utilization of health facilities for delivery., Methods: The University of Calabar Teaching Hospital, the general hospital and eight private clinics in Calabar were visited daily for a period of one month to interview postnatal mothers. This was to ascertain the mothers' perception of obstetric care in these facilities and their attitude towards some selected birth practices., Results: All the interviewed mothers had some formal education, and 133 (92.4%) were aged 20 years and above. One hundred and forty (97.2%) of the mothers were satisfied with at least one aspect of care received. Areas of satisfaction mentioned by the mothers include attitude of health staff 114 (81.4%), clinical care received 85 (60.7%), sanitation of the facility 61 (43.6%), and basic amenities 47 (33.6%), poor sanitary condition of the health facility and lack of basic amenities were the major causes of dissatisfaction. Few mothers, 31 (22%) disagreed with dorsal position during second stage of labor. Most mothers, 92 (63.9%) would want pain relief in labor; 19 (13.2%) did not appreciate shaving of pubic hair and 50 (34.7%) felt episiotomy was not necessary for safe delivery., Conclusion: To improve the utilization of obstetric services in Calabar, basic amenities such as water and sanitation should be provided; and there should be restriction of routine birth practices that have no evidence of effectiveness.

Objective: To determine the magnitude of and the reasons for missed opportunities to immunise with tetanus toxoid at a tertiary health institution in Nigeria. The information obtained would be used in developing an intervention strategy for eliminating missed opportunities in the future., Design: Missed opportunity was assessed by using the Revised WHO/EPI protocol (WHO/EPI/MLM/91.7). Exit interviews were carried out on pregnant women visiting the antenatal (prenatal) clinic to register the present pregnancy., Setting: A tertiary health institution in Nigeria., Subjects: Pregnant women who attended the antenatal clinic for the purpose of registering the present pregnancy during the last two booking days in February, 1997 and the first booking day in March, 1997., Main Outcome Measures: Missed opportunities and contributory factors., Results: The prevalence of missed opportunity was 66%. The factors responsible for missed opportunity were poor history taking, lack of knowledge of the current schedule of immunisation, dependence on physician referral for immunisation and inefficient immunisation record keeping system., Conclusion: The findings establish the need for providing physicians in antenatal settings with an update on current immunisation policy and practice and for improved documentation of immunisation histories.