The seeking of healthcare for childhood illnesses was studied in three rural Nigerian communities of approximately 10,000 population each. The aim was to provide a baseline understanding of illness behaviour on which to build a programme for the promotion of prepackaged chloroquine and cotrimoxazole for early and appropriate treatment of childhood fevers at the community level. A total of 3117 parents of children who had been ill during the 2 weeks prior to interview responded to questions about the nature of the illness and the actions taken. Local illness terms were elicited, and the most prevalent recent illness and the actions taken. Local illness terms were elicited, and the most prevalent recent illnesses were 'hot body' (43.9 per cent), malaria, known as iba (17.7 per cent), and cough (7.4 per cent). The most common form of first-line treatment was drugs from a patent medicine vendor or drug hawker (49.6 per cent). Only 3.6 per cent did nothing. Most who sought care (77.5 per cent) were satisfied with their first line of action, and did not seek further treatment. The average cost of an illness episode was less than US$2.00 with a median of US$1.00. Specifically, chloroquine tablets cost an average of US 29 cents per course. Analysis found a configuration of signs and symptoms associated with chloroquine use, to include perception of the child having malaria, high temperature and loss of appetite. The configuration positively associated with antibiotic use consisted of cough and difficult breathing. The ability of the child's care-givers, both parental and professional, to make these distinctions in medication use will provide the foundation for health education in the promotion of appropriate early treatment of childhood fevers in the three study sites.

This study has shown that obesity and its primary co-morbidities are emerging as a serious health problem among the study population, with class I obesity being the most common pattern and hypertension being the most common primary co-morbidity. Anthropometric determination of obesity and screening for its common primary co-morbidities should be integrated as part of the clinic baseline assessment of adult Nigerians attending rural hospitals to facilitate their early detection and institutionalization of appropriate preventive and therapeutic measures.

Background: Obesity is socially and culturally acceptable in Nigeria and therefore not usually recognized as a medical problem. This study is aimed at determining the prevalence of obesity using body mass index(BMI) criterion and its common primary comorbidities among adult Nigerians attending a semiurban Mission General Hospital in Imo state, South-Eastern, Nigeria. Methods: A descriptive study using primary data collection technique was carried out from October 2007 to December 2008. A total of 9296 consecutive new adult patients aged 18-88 years were screened for obesity using BMI criterion and 684 patients who had 2 BMI=30 kg/m met the inclusion criteria. The data collected included age, sex, marital status, education, occupation, weight(kilogram), height(meters), and blood pressure; fasting blood sugar and fasting lipid profile. Obese patients' perception of their obese condition and knowledge of lifestyle modification were also assessed. Results: Six hundred and eighty-four(7.4%) out of a total of 9296 patients screened for obesity were obese. Hypertension(18.4%) was the commonest primary comorbidity, others include high triglyceridaemia(9.2%), high total cholesterol(8.2%), high LDLcholesterol(6.0%) and diabetes mellitus(3.4%). One hundred and one(14.8%) obese patients were aware of their obese condition and majority, 72(71.3%) of them were informed of their obese condition by healthcare professionals. Forty seven(46.5%) of those who were aware of their obese condition had knowledge of lifestyle modification. However, majority(72.3%) of those who had knowledge of lifestyle modification demonstrated low knowledge level of lifestyle modification. Conclusion:This study has shown the existence of obesity and its common primary co-morbidities among the study population. Anthropometric determination of obesity and screening for its common primary co-

Exclusive breastfeeding (EBF) requires that the child be started on breastmilk on the first day of life and to continue with breastmilk alone for the next 4-6 months. EBF is compromised even when water is given to a child. This study surveyed the breastfeeding practices and opinions of 411 mothers of children aged 4-28 months in the rural community of Igbo-Ora in southwestern Nigeria. While all children were given breastmilk throughout that period, all received plain water during the first week of life. Herbal tea was given to nearly half (47 per cent) during their first week, and by the fourth month 97 per cent had taken herbs. Glucose water was commonly given during the first week (72 per cent). In-depth interviews with health workers confirmed that they gave advice to use glucose water for newborns. Only 45 (11 per cent) of women practised what could be termed predominantly breastfeeding (PBF), i.e. giving only plain water and/or herbal tea in the first 4 months. These were primarily women with some education and in skilled occupations. Mothers believed that breastmilk alone would not satisfy their children and would be physically draining on themselves because the current economic hard times did not allow them to eat as they wished. The results imply a need for health education that starts with the health workers themselves and addresses the cultural context of the mothers' fears about EBF.

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