Oncogenic human papilloma virus infection among women attending the cytology clinic of a tertiary hospital in Lagos, South-West Nigeria

Background:Cervical cancer is the most common gynaecological cancer and a leading cause of cancer death in women in Nigeria. Persistence infection with high risk or oncogenic Human Papillomavirus (HPV) types is now known to be a necessary cause of cervical cancer.Methods:This study is a descriptive cross-sectional study carried out to determine the prevalence and distribution of oncogenic HPV infection among women seen at the cytology clinic of a tertiary hospital in Lagos South-west Nigeria and then identify the likely predisposing factors to this infection. Eligible women were selected by consecutive sampling method for the study. Pap smear and endocervical swab samples were collected from each participant. The endocervical swab samples were screened for HPV types 16, 16A, 31, 33 and 35 by the multiplex Polymerase Chain Reaction (PCR) using the specific primers for the HPV types.Results: Twenty-four (30.4%) of the 79 tested swab samples were positive for viral DNA of high risk HPV 16. There was a statistically significant difference in the mean ages of participants with positive cervical HPV and those without the infection respectively (34.8 ± 9.9 vs. 46.2 ± 10.1 years; P = 0.028). However, there were no significant differences found between the women with HPV positivity and those without with respect to marital status (P = 0.074), tribe (P = 1.009), religion (P = 0.681) and educational status (P = 0.552). Other identified risk factors that showed statistically significant differences for oncogenic HPV infection were age at sexual debut (P = 0.009), parity (P = 0.003), number of lifetime sexual partner(s) (P = 0.000), use of combined oral contraceptives (P = 0.044), HIV seropositivity (P = 0.000) and smoking (P = 0.033).Conclusion:Cumulative high risk HPV infection is high in Lagos, Nigeria. This thus support the need for routine and early screening of all identified high risk sexually active women for HPV infection in Nigeria, as well as emphasising further the importance of sex education for the girl child in schools and increased awareness for parents towards HPV vaccination for their generally healthy adolescent girls.

Perinatal outcome in anaemic pregnant women in South-Western Nigeria

Background: Anaemia in pregnancy is a global public health problem in most developing and developed countries with major consequences for human health as well as social and economic development. Fetuses of anaemic mothers are at risk of preterm deliveries, low birth weights, morbidity and perinatal mortality due to the impairment of oxygen delivery to placenta and foetus.Methods: This study was conducted at the antenatal clinic and labour ward complex of a teaching hospital in south-western Nigeria to determine the effect of anaemia in pregnancy on perinatal outcome. Eligible participants were enrolled for the study by consecutive sampling method. Relevant data were extracted from the case records of these eligible women and a structured interviewer administered questionnaire was used for the data collection.Results: There were statistically significant differences between anaemia and reduced gestational age at birth (P = 0.000), low one-minute (P = 0.000) and five-minute (P = 0.003) Apgar scores, reduced birth weight (P=0.005) and foetal death (P = 0.013). No significant difference was noted in the rate of neonatal admission in the two groups (P = 0.085).Conclusion: This study has thus highlighted the importance of considering maternal anaemia as an indicator of adverse perinatal outcomes. There is therefore, a need to counsel intending mothers and their partners about early antenatal booking, compliance with routine antenatal medications and prompt identification and treatment of anaemia in pregnancy, all as means of curtailing the overwhelming perinatal morbidity and mortality associated with the condition.

Chlamydia trachomatis among women with normal and abnormal cervical smears in Lagos, Nigeria

Background: Chlamydia trachomatis is one of the most common sexually transmitted disease agents. Cervical intraepithelial neoplasia (CIN) has been independently associated with serological evidence of chlamydial infection. This study therefore was aimed to determine the prevalence of C. trachomatis and the association between Chlamydia trachomatis infection and cervical intra-epithelial lesion.Methods: It is a cross-sectional case control study carried out at the Lagos University Teaching Hospital (LUTH) with the study participants selected into 2 groups: the case group (women with abnormal smears) and the control group (women with normal Pap smear). Relevant information was obtained using a structured interviewer-administered questionnaire. Endocervical swab sample was collected and analysed by Polymerase Chain Reaction (PCR) test. Data analysis was done using Epi-Info statistical package (version 3.4.3).Results: The overall prevalence of C. trachomatis was 27.7% with a decreasing trend noted with age (P <0.05). The majority of women with C. trachomatis were in the reproductive age group of 25-45 years. 50% of women with abnormal smears were positive for C. trachomatis, compared to only 16.7% of the controls (X2 = 10.95; P = 0.001). There was no statistically significant association between prevalence of C. trachomatis and cervical cytological types (X2 = 1.892; P = 0.595)Conclusions: The study revealed an association between Chlamydia trachomatis and precancerous lesions of the cervix. Routine screening and treatment of sexually active adolescents and women in the reproductive age group is recommended as an indirect measure to reducing the incidence of cervical cancer in Nigeria

Preterm delivery and low maternal serum cholesterol level: any correlation?

Background: Preterm birth is a major challenge in perinatal health care with prematurity accounting for 40-60% of all perinatal deaths in Nigeria. The physiologic hypercholesterolaemia of later pregnancy suggests an adaptive function for pregnancy maintenance or fetal growth. Decreased levels of maternal total cholesterol and low-density lipoprotein cholesterol have been reported in association with preterm delivery.Methods: This was a prospective observational cohort study designed to assess whether low maternal serum cholesterol during early pregnancy is associated with preterm delivery in these women. Eligible participants were enrolled for the study at gestational age of 14 to 20 weeks over a period of 12 months. Blood samples were obtained to measure total serum cholesterol concentrations and the sera were then analyzed enzymatically by the Cholesterol Oxidase: p-Aminophenazone (CHOD PAP) method.Results: The study showed an incidence of 5.0% for preterm delivery in the low risk study patients. Preterm birth was 4.83-times more common with low total maternal cholesterol than with midrange total cholesterol (11.8% versus 2.2%, P = 0.024).Conclusions: We can infer from the study that the low maternal serum cholesterol (hypocholesterolaemia) is associated with preterm delivery. We can therefore recommend on this basis that the concept of an optimal range for maternal serum cholesterol during pregnancy may have merit and pregnant women should be encouraged to follow a healthy, balanced diet and ensure regular antenatal visit to their healthcare provider

A critical review of complementary and alternative medicine use by women with cyclic perimenstrual pain and discomfort: a focus upon prevalence, patterns and applications of use and users' motivations, information seeking and self-perceived efficacy

© 2016 Nordic Federation of Societies of Obstetrics and Gynecology Introduction: Complementary and alternative medicine (CAM) is used for treating cyclic perimenstrual pain and discomfort. This critical review examines women's reported CAM use, its perceived effectiveness and information relating to women's attitudes, behaviors, motivations and patterns of CAM use in its treatment. Material and methods: An extensive search of the main medical databases EBSCO, CINAHL, Medline, AMED and SCOPUS, as well as additional hand searches, was conducted. Papers included were confined to those that had been peer-reviewed, written in English and that contained original research into CAM use for cyclic perimenstrual pain and discomfort among adult women. Results: CAM, particularly herbal medicine, nutritional supplements and massage, is widely used for a range of cyclic perimenstrual pain and discomfort symptoms. A large number of CAM modalities are adopted, often simultaneously and with little professional oversight. Women's assessment of efficacy of different CAM modalities is positive, though the majority of users are self-prescribing apparently without professional guidance. Although the uptake of CAM for cyclic perimenstrual pain and discomfort is widespread, few empirical data are available regarding which women are using CAM, their motivations for doing so and, importantly, the sources through which women receive information about CAM. Conclusions: This review highlights the extensive use of (often self-prescribed) CAM in a number of countries to alleviate the widespread symptoms of cyclic perimenstrual pain and discomfort. An understanding of all health care use by women with perimenstrual pain and discomfort is vital to help ensure safe, effective and coordinated health care that can lead to optimal patient outcomes

A multi-template multiplex PCR assay for hepatitis B virus and human β-globin

The Hepatitis B surface antigen (HBsAg) is the hallmark of HBV infection. Detection of antibodies to HBs and the core (i.e. HBsAg and HBcAb) are primary serological algorithms in the laboratory diagnosis of HBV. Detection of HBsAg DNA is an important supplement to serological diagnosis especially in clinical cases. Simultaneous amplification of internal cellular controls is a good indicator of sample quality. Human P-globin is a well characterised housekeeping gene (HKG) that is often applied as internal controls (IC) in molecular diagnosis. In this study, individual plasmid clones of the human P-globin and HBs genes were constructed. These plasmid constructs have been applied to characterise a multiplex PCR assays for HBs and P-globin genes. The findings suggest detection limits of less than 10 genome copies of either template In vitro using conventional and multiplex PCR conditions. Under the multiplex conditions, co-amplification of P-globin and HBsAg DNA had a resultant effect on assay sensitivity. This study further highlights the importance of molecular diagnosis in HBV infectious individuals. If fully optimised, this assay could provide a possible diagnostic complement to serological detection in developing countries

The use of complementary and alternative medicine by 7427 Australian women with cyclic perimenstrual pain and discomfort: A cross-sectional study

© 2016 Fisher et al. Background: To assess the prevalence of cyclic perimenstrual pain and discomfort and to detail the pattern of complementary and alternative (CAM) use adopted by women for the treatment of these symptoms. Methods: Data from the 2012 national Australian Longitudinal Study of Women's Health (ALSWH) cross-sectional survey of 7427 women aged 34-39 years were analysed to estimate the prevalence of endometriosis, premenstrual syndrome (PMS), irregular or heavy periods and severe dysmenorrhoea and to examine the association between their symptoms and their visits to CAM practitioners as well as their use of CAM therapies and products in the previous 12 months. Results: The prevalence of endometriosis was 3.7 % and of the perimenstrual symptoms assessed, PMS was most prevalent at 41.2 % whilst irregular bleeding (22.2 %), heavy periods (29.8 %) and severe period pain (24.1 %) were reported at lower levels. Women with endometriosis were more likely than non-sufferers to have consulted with a massage therapist or acupuncturist and to have used vitamins/minerals, yoga/meditation or Chinese medicines (p < 0.05). PMS sufferers were more likely to consult with an osteopath, massage therapist, naturopath/herbalist or alternative health practitioner and to have used all forms of CAM therapies except Chinese medicines than women who had infrequent PMS (all p < 0.05). Women with irregular periods did not have different patterns of CAM use from non-sufferers and those with heavy periods did not favour any form of CAM but were less likely to visit a massage therapist or use yoga/meditation than non-sufferers (p < 0.05). For women with severe dysmenorrhoea there was no difference in their visits to CAM practitioners compared to non-sufferers but they were more likely to use aromatherapy oils (p < 0.05) and for more frequent dysmenorrhoea also herbal medicines, Chinese medicines and other alternative therapies compared to non-sufferers (all p < 0.05). Conclusions: There is a high prevalence of cyclic perimenstrual pain and discomfort amongst women in this age group. Women were using CAM differentially when they had specific symptoms of cyclic perimenstrual pain and discomfort. The use of CAM needs to be properly assessed to ensure their safe, effective use and to ascertain their significance as a treatment option enabling women with menstrual problems and their care providers to improve their quality of life

Seroprevalence of Hepatitis B Virus Infection among Pregnant Women at the Antenatal Booking Clinic of a Tertiary Hospital in Lagos Nigeria

Objectives: The objectives were to determine the seroprevalence of hepatitis B virus (HBV) infection and assess the major risk factors among Nigerian pregnant women.Subjects and Methods: This was a cross‑sectional descriptive study carried out among pregnant women at the antenatal clinic of a Tertiary Hospital in Lagos, Nigeria. A total number of 150 consenting pregnant women were selected for the study. A structured pretested interviewer‑administered questionnaire was used for the data collection. Sera were collected and tested for hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg).Results: Of the150 women screened during the study, 11 (7.3%) were seropositive for HBsAg. Of these 11 women, 4 (36.4%) were also positive for HBeAg. There was no statistically significant difference in the mean ages of participants who were seropositive for HBsAg and those who were negative for the virus (P = 0.888). There were statistically significant differences in the seroprevalence of HBsAg recorded among respondents with previous surgery (odd ratio [OR] ‑ 2.97; 95% confidence interval [CI] ‑ 1.08‑16.67; P = 0.046), previously affected sibling or spouse (OR ‑ 5.03; 95% CI ‑ 1.11–25.27; P = 0.001) and those with two or more lifetime sexual partners (OR ‑ 4.11; 95% CI ‑ 2.85–9.22; P = 0.024).Conclusion: The sero‑prevalence rate of HBV infection and also its infectivity is high in Lagos, Nigeria. These findings thus support the need for a nationwide policy of routine and widespread HBV screening among pregnant women.Keywords: Hepatitis B Surface Antigen, Hepatitis B Virus, Infectivity, Lagos, Nigeria, Seroprevalenc